A Guide to Estimating Conditional Average Treatment Effects in Competing Risks Settings

A wide range of statistical and machine learning methods have been proposed for survival analysis with competing risks, where the occurrence of one event (i.e., cancer death) precludes the occurrence of other events (i.e., cardiovascular disease death). Despite these methodological advances, their systematic evaluation and adoption are limited by the lack of comprehensive, reproducible and extensible benchmarking frameworks. We developed an open-source benchmarking framework for competing risks models that enables their systematic comparison across multiple datasets under different aspects of performance; calibration, discrimination, overall prediction error and clinical utility. We additionally introduce an extension of SHAP for competing risks, allowing model-agnostic interpretability of covariates contributions over time. All our code is publicly available via GitHub:https://github.com/BBolosSierra/CompRisksBenchmark

Conditional Average Treatment Effect (CATE) estimation in practice demands three properties simultaneously: heterogeneous effects $τ(x)$, calibrated uncertainty over them, and robustness to the heavy tails that contaminate real outcome data. Meta-learners (Künzel et al., 2019) give (i); causal forests and BART give (i)-(ii) with Gaussian-tail assumptions; no widely used tool gives all three. We present Bayesian X-Learner, an X-Learner built on cross-fitted doubly robust pseudo-outcomes (Kennedy, 2020) with a full MCMC posterior over $τ(x)$ via a Welsch redescending pseudo-likelihood. On Hill's IHDP benchmark the default configuration attains mean $\sqrt{\varepsilon_{\mathrm{PEHE}}} = 0.56$ on 5 replications (lowest mean; differences from S-/T-/X-learners, full-config Causal BART, and a causal forest baseline are not significant at $α=0.05$, and rank ordering is unstable at 10 replications -- IHDP comparisons are competitive rather than dominant). On contaminated "whale" DGPs with up to 20-25% tail density, a one-flag extension (contamination_severity) that selects a Huber-$δ$ nuisance loss per Huber's minimax-$δ$ relation recovers RMSE $\approx 0.13$ with tight credible intervals (single-cross-fit 30-seed coverage 83% [Wilson 66%, 93%] at 20% density; modular-Bayes pooling with Bayesian-bootstrap nuisance draws restores nominal 95% coverage).

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.