Doubly Robust Learning of Heterogeneous Survival Treatment Effects under Time-Varying Treatments

Estimating heterogeneous treatment effects (HTEs) from right-censored survival data is critical in high-stakes applications such as precision medicine and individualized policy-making. Yet, the survival analysis setting poses unique challenges for HTE estimation due to censoring, unobserved counterfactuals, and complex identification assumptions. Despite recent advances, from Causal Survival Forests to survival meta-learners and outcome imputation approaches, evaluation practices remain fragmented and inconsistent. We introduce SurvHTE-Bench, the first comprehensive benchmark for HTE estimation with censored outcomes. The benchmark spans (i) a modular suite of synthetic datasets with known ground truth, systematically varying causal assumptions and survival dynamics, (ii) semi-synthetic datasets that pair real-world covariates with simulated treatments and outcomes, and (iii) real-world datasets from a twin study (with known ground truth) and from an HIV clinical trial. Across synthetic, semi-synthetic, and real-world settings, we provide the first rigorous comparison of survival HTE methods under diverse conditions and realistic assumption violations. SurvHTE-Bench establishes a foundation for fair, reproducible, and extensible evaluation of causal survival methods. The data and code of our benchmark are available at: https://github.com/Shahriarnz14/SurvHTE-Bench .

Estimation of heterogeneous long-term treatment effects (HLTEs) is relevant for personalized decision-making in marketing, economics, and medicine, where short-term observational datasets are often combined with long-term observational datasets. However, HLTE estimation is challenging due to limited overlap in treatment assignments or in long-term outcomes for certain subpopulations, which can lead to unstable HLTE estimates with large finite-sample variance. To address this challenge, we introduce the LT-O-learners (Long-Term Orthogonal Learners), a set of novel orthogonal learners for HLTE estimation in the canonical HLTE setting with surrogacy. The key idea of our LT-O-learners is to retarget the loss via custom overlap weights that downweight low-overlap samples. We show that the retargeted loss recovers the true HLTE pointwise and satisfies Neyman-orthogonality. We further prove two key theoretical results: (i) The nuisance error enters the error bound only through higher-order terms, which means our learners are robust to nuisance estimation error. (ii) Under a linear function class, the retargeting effectively controls the asymptotic variance of the HLTE estimator via the overlap weights in low-overlap regimes. We conduct experiments on synthetic and real-world datasets to confirm the theoretical properties of our LT-O-learners, particularly robustness in low-overlap regimes. To our knowledge, ours are the first orthogonal learners for HLTE estimation robust to low overlap in long-term settings.

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.