Adaptive Experimentation for Censored Survival Outcomes
Authors: Yuxin Wang, Dennis Frauen, Jonas Schweisthal, Maresa Schröder, Emil Javurek, Stefan Feuerriegel
Abstract
Adaptive experimentation enables efficient estimation of causal effects, but existing methods are not designed for survival data with censoring, where event times are only partially observed (e.g., overall survival in cancer trials but with dropout). In this paper, we develop a novel framework for adaptive experimentation to estimate causal effects under right censoring. For this, we derive the semiparametric efficiency bound for the average survival effect curve as a function of the treatment allocation policy and thereby obtain a closed-form efficiency-optimal allocation policy. The policy generalizes classical Neyman allocation to survival settings by prioritizing patient strata where both event and censoring dynamics induce high uncertainty. Building on this, we propose the Adaptive Survival Estimator (ASE), an adaptive framework that learns the allocation policy and estimates the average survival effect curve sequentially. Our framework has three main benefits: (i) it accommodates arbitrary machine learning models for nuisance estimation; (ii) it is guided by a closed-form efficiency-optimal allocation policy; and (iii) it admits strong theoretical guarantees, including asymptotic normality via a martingale central limit theorem. We demonstrate our framework across various numerical experiments to show consistent efficiency gains over uniform randomization and censoring-agnostic baselines.
We present a regression-adjustment framework designed for the estimation of longitudinal treatment effects in randomized experiments under static regimes. While regression-adjustment methods are useful for variance reduction in randomized experiments by using pre-treatment covariates, they usually focus only on average effects, from which we cannot obtain valuable insights into when the effects appear and how long they continue. To address this issue, we consider intermediate outcomes and evolving post-treatment covariates over time, and we represent such dynamic trajectories using transition kernels. Furthermore, we establish the asymptotic normality and the semiparametric efficiency bound for our estimator, enabling more powerful statistical inference. Simulation studies and empirical analysis using A/B test data from a streaming platform in Japan show the practical advantages of our method.
Survival Analysis (SA) is a statistical framework that models the time span until some event of interest occurs. Widely used in several domains, including healthcare and churn prediction, a central challenge in its applicability stems from the time of the event being partially observed or \emph{right-censoring}. Tabular Foundation Models (TFM) have attracted significant interest in recent years due to their ability to perform prediction tasks in a single forward pass, requiring no dataset-specific parameter fitting. Despite their success, their application to prediction tasks on time-to-event data remains difficult due to right censoring. In this work, we present a training-free method to survival regression by leveraging TFMs to both predict the time of the event and iteratively impute right-censored data. Our method uses a TFM to construct an Accelerated Failure Time (AFT) model requiring no training beyond fitting a single scalar parameter. Subsequently, by building on the Buckley-James estimator, we introduce a non-parametric in-context estimator for right-censored data. Our experiments on standard survival analysis benchmarks show that our method is competitive with several parametric and semi-parametric survival regression models that require training, including Cox regression and parametric AFT models.
Conditional average treatment effects (CATEs) are central to treatment decision-making in personalized medicine. In competing risks settings, estimating CATEs from survival data allows for patient-specific assessments of treatment effectiveness for a specific event of interest while properly accounting for alternative event types. This distinction is essential in the presence of comorbidities, where competing causes of death may otherwise confound the therapeutic benefit. Focusing on right-censored survival times with binary treatment, we examine CATEs defined as covariate-conditional differences in the absolute risk for the event of interest at a fixed time. To this end, we study meta-learners which adapt machine learning algorithms for CATE estimation in competing risks scenarios. We systematically compare six meta-learners, combining Cox regression or random survival forests for risk modeling with elastic net regression or random forests for direct CATE modeling. To provide practical guidance on model selection, we evaluate their performance in multiple simulation settings, that differ in hazard complexity, treatment heterogeneity, treatment assignment, event type distribution and censoring. To facilitate applied use, we provide the R package, crsurvlearners, which implements all considered approaches.