SurvTRACE: transformers for survival analysis with competing events

Abstract

In medicine, survival analysis studies the time duration to events of interest such as mortality. One major challenge is how to deal with multiple competing events (e.g., multiple disease diagnoses). In this work, we propose a transformer-based model that does not make the assumption for the underlying survival distribution and is capable of handling competing events, namely SurvTRACE. We account for the implicit confounders in the observational setting in multi-events scenarios, which causes selection bias as the predicted survival probability is influenced by irrelevant factors. To sufficiently utilize the survival data to train transformers from scratch, multiple auxiliary tasks are designed for multi-task learning. The model hence learns a strong shared representation from all these tasks and in turn serves for better survival analysis. We further demonstrate how to inspect the covariate relevance and importance through interpretable attention mechanisms of SurvTRACE, which suffices to great potential in enhancing clinical trial design and new treatment development. Experiments on METABRIC, SUPPORT, and SEER data with 470k patients validate the all-around superiority of our method. Software is available at https://github.com/RyanWangZf/SurvTRACE.