用图模型模拟临床路径,提升头颈癌生存预测精度。
ChronoSurv: A Clinical Pathway-Guided Graph Framework for Multimodal Survival Analysis

- 构建动态临床路径图,融合多模态数据时序关系。
- 在两个公开数据集上达到当前最优判别性能。
- 适合关注精准医疗与临床流程建模的研究者。
头颈癌的精准生存预测对个性化治疗至关重要,但因多模态临床数据异质性强、维度高而面临挑战。尽管深度生存模型已超越传统统计方法,现有方法多依赖静态融合或忽略时间信息,难以捕捉结构化临床流程。本文提出ChronoSurv,一种面向多模态生存分析的异构分层有向图框架。该模型将患者诊疗过程建模为与关键诊断步骤对齐的进展感知轨迹,通过分层拓扑整合细粒度、粗粒度与全局表示,支持缺失模态的灵活适应;异构消息传递机制有效建模跨模态与临床阶段的复杂非对称关系。在两个公开数据集上的实验表明,ChronoSurv实现当前最优判别性能,并保持统计可靠的校准性。全面消融研究验证了各组件贡献,凸显轨迹感知图建模在多模态生存预测中的潜力。
原文摘要 · Abstract (English)
Accurate survival prediction is essential for personalized treatment planning in head and neck cancer, yet remains challenging due to the heterogeneous and high-dimensional nature of multimodal clinical data. While deep survival models have improved predictive performance over classical statistical approaches, existing methods typically rely on static fusion strategies or temporally agnostic modeling, limiting their ability to capture structured clinical workflows. In this work, we propose ChronoSurv, a heterogeneous hierarchical directed graph framework for multimodal survival analysis. ChronoSurv represents patient care as a progression-aware clinical trajectory using directed graphs aligned with key diagnostic steps. A hierarchical topology incorporates fine-grained, coarse, and global representations, further supporting flexible adaptation to missing modalities, while heterogeneous message passing models complex and asymmetric relationships across modalities and clinical steps. Experimental results on two public datasets demonstrate that ChronoSurv achieves state-of-the-art discriminative performance while maintaining statistically reliable calibration. Comprehensive ablation studies further confirm the contribution of each architectural component, highlighting the potential of trajectory-aware graph modeling for multimodal survival prediction.
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