arXiv:2602.01367cs.LGcs.AI2026-02

用对比学习提升生存分析可解释性,兼顾预测精度与风险分组

Deep Variational Contrastive Learning for Joint Risk Stratification and Time-to-Event Estimation

  • 将变分自编码器与对比学习结合,生成可解释的风险分组
  • 在4个基准数据集上达到领先或相当的预测性能
  • 适合需兼顾模型可解释性与临床实用性的医疗AI研究者

生存分析对临床决策至关重要,可估计事件发生时间、划分患者风险等级并指导治疗。深度学习虽大幅提升预测能力,但其黑箱特性限制了临床应用;而基于深度聚类的风险分组方法往往牺牲预测性能。本文提出CONVERSE(CONtrastive Variational Ensemble for Risk Stratification and Estimation),通过联合变分自编码器与对比学习实现可解释的风险分组。该模型融合变分嵌入与多层级对比损失(包括簇内和簇间),采用自适应学习策略逐步引入难样本以提升训练稳定性,并支持每个簇独立的生存头,实现精准集成预测。在4个基准数据集上的全面评估表明,CONVERSE在保持有意义患者分组的同时,性能优于或媲美现有深度生存模型。

原文摘要 · Abstract (English)

Survival analysis is essential for clinical decision-making, as it allows practitioners to estimate time-to-event outcomes, stratify patient risk profiles, and guide treatment planning. Deep learning has revolutionized this field with unprecedented predictive capabilities but faces a fundamental trade-off between performance and interpretability. While neural networks achieve high accuracy, their black-box nature limits clinical adoption. Conversely, deep clustering-based methods that stratify patients into interpretable risk groups typically sacrifice predictive power. We propose CONVERSE (CONtrastive Variational Ensemble for Risk Stratification and Estimation), a deep survival model that bridges this gap by unifying variational autoencoders with contrastive learning for interpretable risk stratification. CONVERSE combines variational embeddings with multiple intra- and inter-cluster contrastive losses. Self-paced learning progressively incorporates samples from easy to hard, improving training stability. The model supports cluster-specific survival heads, enabling accurate ensemble predictions. Comprehensive evaluation on four benchmark datasets demonstrates that CONVERSE achieves competitive or superior performance compared to existing deep survival methods, while maintaining meaningful patient stratification.

生存分析可解释性对比学习医疗AI

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