Survival Analysis

Deep learning models for dynamic survival analysis (DSA) achieve strong predictive performance by incorporating longitudinal patient data, but their black box nature limits clinical trust and adoption. Existing explainability methods cannot handle longitudinal, irregular inputs and functional survival outputs simultaneously, which limits their usability in DSA. We propose DynSHAP, a SHAP framework suited specifically for dynamic survival analysis. It extends common marginal SHAP estimators to this setting by treating time--feature pairs as players in the Shapley game. We further introduce Temporal DynSHAP, which learns linear dependencies in features over time and uses conditional sampling to address them in explanations. When applied to synthetic data with known ground-truth attributions, Temporal DynSHAP recovers temporally dependent features more accurately than marginal estimators for a given state-of-the-art model. Applied to two real-world clinical datasets and two DSA architectures, DynSHAP produces attributions faithful to model learning, allowing medical experts to see which patient information drove the prediction and when.

Patient exams in the cancer diagnosis and staging process typically generate several whole slide images (WSIs). One of the initial steps in training models on WSI data is identifying one or a few slides containing tumor or other diagnostic biomarkers necessary for downstream prediction tasks such as estimating recurrence risk or progression-free survival. This step requires tedious manual curation by experienced pathologists. Many published datasets make the artificial assumption of 1 slide per patient. Alternatively, all slides per patient may be used for model training, which may dilute the signal from the few slides containing tumor or other relevant information. In this paper, we present a pipeline to overcome these challenges using publicly available WSI foundation models (FMs). Our evaluations show that ranking WSIs based on predictions from zero-shot classification using WSI FMs accurately identifies slides with the most tumor, indicating that WSI FMs contain sufficient morphology signal to automatically triage slides. We also present a formulation for ranked evaluation to benchmark FM performance in slide triage. We show, on multiple datasets, that tumor slides are identified in the top-2 ranked slides for patients with up to 43 slides.

Repurchase recommenders in e-commerce are commonly framed as a binary question asking "will this customer buy this item within W days", a formulation that requires a separately trained model for every horizon of interest. We replace this stack with survival models that predict time-to-repurchase directly, and evaluate them on millions of customers from a major grocery e-commerce platform across more than thirty ablation configurations. Our study makes three contributions. First, an empirical hazard analysis reveals a slightly decreasing marginal hazard (k ~ 0.9), differing from the common intuition that grocery items become more likely to be repurchased the longer since the last purchase (increasing hazard, k > 1). Log-Normal achieves the best marginal fit (R^2 = 0.998) and the best ranking, despite Weibull providing the best conditional residual fit, revealing an apparent discrepancy we analyze in detail. Second, a single Accelerated Failure Time (AFT) model replaces three per-horizon binary classifiers, matching or exceeding each at its own horizon while using roughly 3x fewer total trees. Feature importance reshuffles under the survival objective: channel-cadence and recency signals rise while aggregate frequency counts fall. Third, a 4-parameter parametric calibration maps raw survival CDFs to per-horizon probabilities with zero cross-horizon monotonicity violations. Calibration quality varies by an order of magnitude across the AFT family: Exponential AFT (Weibull k=1) achieves expected calibration error (ECE) ~1e-4, roughly 10x lower than Log-Normal, while ranking metrics agree within 0.3% relative. We adopt Exponential AFT for probability-consuming surfaces and Log-Normal for pure ranking, exposing a principled calibration-ranking trade-off within a single AFT family.

Long-running agents periodically compact their context, replacing the transcript with a model-generated summary. Recent work shows that dropping a standing safety constraint during compaction drives behavioral violations across many models (Governance Decay; Chen, 2026). We ask a finer question: under a single compaction cycle, how is a safety rule lost, and what does that imply for detection and evaluation? Our central finding is that a presence check is not a safety check: when compaction does not drop a rule outright, it often leaves something that looks like a rule but does not act like one. On behavioral replay, a degraded residue leads the model to perform the prohibited action far more often than an intact welded rule does (all-case gaps of +34 and +57 points under two replay models, both positive), category-level survival behaves like a residue, and even intact rules sometimes fail to fire, so an audit that checks only textual presence gives false assurance. Sharpening this, rule-form items are retained substantially more often than prominence-matched facts, which is exactly why presence-based checking feels adequate even though survival is not protection. Textual loss is regime-dependent (weld-or-drop with a single rule; degraded predicate-loss residues under a tighter budget), and we did not observe the hypothesized textual severing mode. Such loss is silent at runtime and detectable only by comparison with retained external ground truth (such as a constraint registry), which reveals textual absence but not whether a surviving rule still fires. We also document evaluation pitfalls where LLM-judge labels alone would have reversed a conclusion. All results concern a single compaction cycle.

How a document's arrangement is written down, its notation, is a training variable that no dataset card records. The field has established that text-extraction choices change model behaviour, and has never once measured the notation of what those choices put into the corpus. We define clean-window survival, a deterministic count of how much of a stream still demands the boundary inference, and measure notation on three fronts. What corpora carry: a census of thirteen public corpora, where survival falls to 0.153 in a vision-converted PDF slice against 0.889 in C4; the scarce resource is not unmarked text but long unmarked text; a pre-registered supply test finds what remains institutional, not consumer. Our own pre-registered prediction failed: converters do not fabricate structure on prose, and that null forced the reliability mechanism that survives it. What readers use: across five base models spanning 0.6B to 8.2B and two pipelines, deleting a structural announcement makes the following prose measurably harder to predict, while swapping its notation moves nothing. That zero does not make notation unimportant; it relocates the variable: the operative cue is the announcement, not the sigil. What writers impose: a bounded null. Base models do not impose the marked register above the authored baseline, and handed prose with every announcement deleted they do not put one back, at a rate indistinguishable from zero against an authored reference of zero. We ship the format those measurements imply: the pure frame, paragraphs in authored order, every announcement deleted into a reversible sidecar, mixed against the marked copy over announcement presence rather than notation. Choose format operators by the capability they train, not by the fidelity they preserve, and record extractor identity and survival on data cards.

Agentic coding faces growing problems of affordability and wasted tokens. We introduce Blast Radius, a predictive memory management layer that estimates an incoming prompt's reach through coupled context and code channels. NECROPHORESIS enables reversible eviction by archiving dead context verbatim, while Recurring Dead Matter (RDM) identifies and buries repeatedly occurring transcripts. We formulate reversible context eviction over a Polish context space, providing a measurable foundation for retention, recurrence, and eviction while connecting context entropy to resurrection probability. Across seven OpenAI models, Blast Radius reduced token consumption by 17-26%, achieved the lowest overflow rate among tested policies, and remained byte exact reversible. Of 450 buried bodies, 378 were recurring dead matter and zero were recalled. Blast Radius operates beneath HCRC, determining which records to bury and how far an incoming prompt may reach into the codebase. This work contributes to the broader goal of Algosophy: making large language models and agentic coding more reusable and sustainable.

This work presents a novel attention-based framework for estimating the Individual Probability of Treatment Benefit (IPTB) in survival analysis contexts. The proposed model, called Surv-IPTB, directly quantifies the probability that a specific patient will experience extended survival time under treatment versus control. We reformulate IPTB estimation as a binary classification problem, leveraging pairwise patient comparisons across treatment and control cohorts. The framework incorporates a principled handling of right-censored observations through imprecise probability representations, where uncertain treatment effects are characterized by interval-valued probabilities. An attention mechanism with learnable query-key transformations enables flexible, data-driven aggregation of pairwise comparisons, while simultaneously learning soft class probabilities for censored cases. Through extensive experiments on synthetic datasets with complex nonlinear structures, including spiral, bell-shaped, and circular feature spaces, we demonstrate that our approach maintains robust performance across varying censoring rates and treatment effect strengths. The model consistently outperforms meta-learner baselines (T-learner and S-learner) equipped with random survival forests, Cox proportional hazards, and Beran estimators, particularly in challenging nonlinear scenarios where conventional methods exhibit significant degradation. The results establish the proposed attention-based framework as a scalable and statistically principled solution for personalized treatment benefit assessment in survival settings. The code implementing the model is publicly available.

Biological systems must regulate competing needs under limited perceptual bandwidth, where sharpening one estimate costs the capacity to sharpen the others. Any fixed-budget system therefore has to decide where to allocate its perceptual precision. We study this in a foraging agent that must keep several bodily needs satisfied to survive, modelled with active inference. At each step it reads its own body-state beliefs, identifies the most-needed channel, and reallocates a fixed budget of interoceptive precision toward it, so that the same precision-shaped likelihood feeds both belief update and planning. In AffectWorld, a four-channel foraging gridworld, this selective allocation more than doubles learning-phase survival at matched budget against a uniform-precision agent ($0.414$ vs $0.199$ across 11 layouts, $n{=}32$ seeds each, paired cluster-bootstrap $p \leq 10^{-4}$). Two further results sharpen the mechanism. The benefit runs through planning as well as perception, since denying the shaped likelihood to the planner alone removes about half of it. It is also need-aligned, since aiming precision at the least-needed channel does worse than spreading it evenly. The attended channel additionally learns its own dynamics about twice as fast, and stays ahead even at matched observation count, a behavioural trace of the same precision routing, visible in learning speed, not survival.

Survival analysis is an established framework for analyzing time-to-event data, yet many clinical machine learning studies still binarize the outcome before model training. This practice excludes censored patients, collapses temporal information into a single threshold, and can affect which features are selected as prognostically relevant. We examine the cost of this binarization in the context of Bayesian network (BN) feature selection, using two recent publications as case studies: one that applies BN-based feature selection to a head-and-neck cancer cohort and a second surgical cohort study that, while not BN-based, likewise binarizes its survival endpoint. We replace the binary scoring function with the Cox partial log-likelihood for feature-to-outcome edges, a modification we call the Survival-Aware Bayesian network, and recover prognostic features that binarization misses. Our ablation experiment confirms that the improvement is driven by the time-to-event scoring formulation rather than by retaining more patients. The results generalize across five endpoint-cohort combinations in head-and-neck cancer and extend to three further cancer types (breast, colorectal, and kidney). We propose that clinical studies with survival outcomes should use time-to-event methods by default, as binarization discards the prognostic signal retained by survival analysis.

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

Robust Optimization Over Time (ROOT) is a recent branch of evolutionary dynamic optimization that seeks solutions capable of remaining effective across multiple consecutive environments. Unlike the traditional track-the-moving-optimum (TMO) paradigm, which reoptimizes after every environmental change, ROOT explicitly values persistence. Although the field has grown considerably, most contributions remain algorithmic and empirical, leaving several fundamental properties poorly understood from a theoretical perspective. One such property is survival time, defined as the number of future environments in which a deployed solution continues to satisfy a prescribed quality threshold. While survival time is widely used as a measure of temporal robustness, little is known about how its expected value depends on environmental dynamics, deployment quality, or problem characteristics. This paper studies expected survival time for a fixed deployed solution under isotropic Gaussian environmental dynamics. Modeling survival as a discrete first-exit problem, we derive a rigorous lower bound and a computable multi-step upper bound. The analysis shows that expected survival scales as $Θ(σ^-{2})$ in slowly varying environments and approaches its minimum value of one future change in high dimensions. A comprehensive Monte Carlo study validates the theoretical predictions, examines sensitivity to modeling assumptions and parameter uncertainty, and illustrates how the bounds can support deployment decisions after optimization. The resulting framework provides an analytical characterization of deployment lifetime and identifies when a required deployment horizon can be guaranteed, ruled out, or remains analytically unresolved.

The rapid emergence of 3D CT foundation models has opened new avenues for predictive modeling from CT imaging, offering a compelling alternative to traditional radiomics which is known to suffer from reproducibility issues and sensitivity to acquisition protocol variations. Yet, as these models grow in availability, a critical need arises to evaluate how well their learned representations generalize across diverse clinical settings and whether adaptation to specific downstream tasks is necessary to unlock their full potential. To address these questions, we benchmarked several 3D CT foundation models for predicting recurrence-free survival in head and neck cancer across two public datasets totaling 3,644 patients, evaluating various adaptation strategies and modality fusion mechanisms. Our findings reveal persistent difficulty in identifying features that generalize consistently across different imaging distributions, as evidenced by significant performance drops on external validation cohorts. Ultimately, the integration of imaging features with clinical data remains the most accurate approach for prognostic prediction, though achieving universal generalization across varied clinical contexts continues to represent a substantial challenge for the current generation of models.

We present HERMES (Hybrid Ensemble for Radiotherapy-target segmentation, Malignancy staging, and Event-free Survival), a single containerized algorithm for the three HECKTOR 2026 subtasks: segmentation of the primary tumor (GTVp) and pathological lymph nodes (GTVn), radiological T/N staging, and recurrence-free survival (RFS), computed from a paired FDG-PET/CT scan and an electronic health record. A 10-fold ensemble of STU-Net Small networks produces the segmentation; the predicted mask then drives two downstream tasks. Rather than pass a generic radiomics vector to the staging models, we derive from the predicted masks a compact set of geometry features aligned with the size and number axes of AJCC/UICC 7th-edition radiological N/T staging. On internal cross-validation these features raise N-stage balanced accuracy from 0.691 to 0.720 (+0.030), our largest single design gain, at lower feature dimensionality. For prognosis we combine complementary deep and clinical risk experts in an equal-weight ensemble, and train one deep expert with a concordance-tracking survival loss of our own, whose value approximates the concordance index during training. Every component was selected on honest out-of-fold predictions under a regularization-oriented protocol, with no tuning on the public validation set, and deployed as two decorrelated submissions. On the HECKTOR 2026 validation leaderboard, HERMES achieved a weighted score of 0.6454 (Mean Dice 0.641, T balanced accuracy 0.580, N balanced accuracy 0.642, RFS C-index 0.679) and qualified for the testing phase. Team: AMC_HNC.

Time-to-event modeling provides a systematic framework for estimating time-dependent failure risk, reliability, and remaining useful life (RUL) from longitudinal condition monitoring data. However, applying these models to distributed prognostics remains challenging because sensor trajectories and failure-time records are often stored across organizations or operational sites and cannot be centrally pooled due to privacy or proprietary constraints. Moreover, the classical Cox proportional hazards model relies on a nonseparable partial likelihood involving global risk sets, making direct optimization difficult under standard federated learning protocols. This paper presents a federated longitudinal-survival modeling framework for collaborative system failure prognostics. The proposed framework combines longitudinal sensor representation learning with a client-separable discrete-time hazard objective, enabling multiple clients to collaboratively train a prognostic model without sharing raw sensor measurements or individual failure records. Time-dependent representations extracted from multivariate sensor histories are used to estimate interval-specific failure hazards, reliability curves, and system RUL. Experiments on the four C-MAPSS turbofan engine degradation subsets under simulated decentralized settings demonstrate that the proposed framework consistently improves prognostic performance over isolated local training while maintaining performance comparable to centralized training across heterogeneous operating conditions and failure modes. These results demonstrate the potential of federated longitudinal-survival modeling for collaborative, data-aware condition monitoring and system failure prognostics.

In this work, we propose K-SurvMeans, a novel extension of K-Means for clustering survival data. The method explicitly uses the survival outcome in the clustering process to optimize cluster centers, thereby maximizing pairwise survival differences between clusters. The objective function encourages the clusters to be well-separated from the survival perspective. Since the resulting optimization problem is non-differentiable, we employ the Particle Swarm algorithm for the Optimization process. To further improve flexibility and mitigate the curse of dimensionality, we extend the framework to operate in a learned low-dimensional latent space obtained via a dimensionality reduction. This allows the method to capture better-separated clusters and enhance optimization efficiency by reducing the search space. Experiments on multiple publicly available benchmark survival datasets demonstrate that K-SurvMeans consistently yields clusters with improved separation in survival distributions compared to existing deep learning-based survival clustering methods.

Radiomic biomarkers derived from magnetic resonance imaging (MRI) have been widely investigated as non-invasive tools for tumor characterization and prognostic modeling in glioblastoma (GBM). However, their clinical translation remains limited, in part due to sensitivity to tumor segmentation variability. In this study, we systematically investigate the relationship between feature robustness and predictive utility in GBM survival modeling using the University of Pennsylvania Glioblastoma Imaging, Genomics, and Radiomics (UPENN-GBM) cohort. A total of 4,752 radiomic features were obtained from multiparametric MRI across three tumor subregions: enhancing tumor (ET), peritumoral edema (ED), and necrotic core (NC). Feature robustness was quantified using the intraclass correlation coefficient (ICC) based on the automatic and expert-refined segmentation versions. Among features with valid ICC estimates, 48.1% were classified as robust. Survival prediction was evaluated using cross-validation with Coxnet, Random Survival Forest, and Gradient Boosting Survival Analysis models. In this cohort, radiomic feature inclusion showed no consistent improvement over the clinical baseline, and robustness filtering produced no detectable performance gain. Model-selected features were less robust than the overall feature pool, indicating a lack of enrichment for robustness. These findings suggest that robustness alone is not a reliable criterion for feature selection in radiomics-based survival modelling.

Predictive maintenance relies on accurate Remaining Useful Life estimation, often formulated using survival analysis over multivariate time-series data. While modern deep survival models achieve strong predictive performance, their black-box nature limits their use in safety-critical settings where actionable insight is required. In this work, we introduce \textit{SurvCF(t)}, the first framework for generating counterfactual explanations for survival models operating on time-series data. \textit{SurvCF(t)} identifies minimal, plausible, and temporally consistent changes to an asset's operational history that increase its predicted life time, framing explanation as a constrained optimization problem combining validity, proximity, sparsity, and plausibility. We evaluate the method on multiple benchmarks, including C-MAPSS, N-CMAPSS, and a real-world case study of the Scania Component_X dataset, demonstrating its ability to produce actionable and interpretable interventions. Our results show that \textit{SurvCF(t)} bridges the gap between survival prediction and prescriptive maintenance, enabling explainable and decision-oriented AI for maintenance strategies.

LLM-based agents are increasingly deployed in multi-agent environments whose incentives can shape their behavior. We introduce The Energy Society, a minimal survival economy for studying how competitive and cooperative incentives affect emergent behavior when inference cost is directly tied to survival: Agents spend energy based on model size when generating tokens, regain energy by completing jobs or receiving donations, and deactivate if their energy reaches zero. We compare competitive and cooperative objectives against a baseline setting and several control variants. Across experiments, larger models consistently consume the most energy and spend more energy than they gain, even in those settings where token cost is not size-dependent. Cooperative incentives substantially alter behavior: agents donate to reactivate others, sometimes at the cost of their own survival, and job allocation changes. Ablations reveal that allowing agents to recommend actions to each other supports coordination and ambitious job selection, while memory helps agents calibrate risk from past outcomes. Agents rarely choose direct sabotage, but show more subtle signs of self-serving behavior in the competitive setting. The Energy Society is a compact testbed for studying the interaction between token costs and group incentives under a survival pressure. Source code is available at https://github.com/LucasBergholdt/EnergySociety

Amyotrophic lateral sclerosis (ALS) is a progressive and heterogeneous neurodegenerative disease in which predicting clinically meaningful milestones, such as assistive device use, remains challenging. We developed a time-to-event, digital-twin-inspired framework that integrates longitudinal ALS Functional Rating Scale-Revised (ALSFRS-R) trajectories with survival modeling to support individualized prediction of functional decline and assistive device utilization. We constructed a harmonized longitudinal dataset by integrating diagnosis records, ALSFRS-R assessments, activities of daily living, and demographic information, followed by preprocessing to ensure data quality, temporal alignment, and cohort consistency. Correlation-based clustering identified coherent functional domains spanning bulbar, upper limb, axial, lower limb, and respiratory systems. Generalized additive mixed models characterized nonlinear, domain-specific functional decline across all domains. In addition, a temporal machine learning model was developed to predict longitudinal functional decline and capture stage-dependent disease progression. Cox proportional hazards modeling further identified lower limb function, particularly walking and stair climbing, as the strongest predictors of earlier wheelchair access. Building on these results, we implemented a digital twin-inspired temporal machine learning-based time-to-event (TTE) model that generates individualized survival curves and dynamically predicts wheelchair-free survival. This framework provides a scalable, interpretable, and clinically actionable approach for linking ALS progression with personalized decision support, with applications in proactive care planning, clinical trial stratification, and precision medicine.

Survival models can model time-to-event outcomes using partially observed data. They are widely used in clinical prediction, including cancer risk, disease progression, treatment response, and mortality. Recent models often rely on rich inputs collected at a specific clinical encounter, such as medical images, laboratory tests, electronic health record snapshots, or sensor measurements. In large retrospective datasets, these inputs are usually collected over many calendar years. As a result, they may contain clues about when they were acquired through changes in devices, protocols, documentation, patient mix, or clinical practice. This creates a potential failure mode when outcomes are observed only up to a fixed study end date. More recent records necessarily have less potential follow-up than older records. A model that can infer the record date from the input may therefore learn to predict how much follow-up was available rather than the patient's true risk of experiencing the event. We call this failure mode administrative-cutoff leakage. In this paper, we characterize when this leakage can occur, distinguish it from classical informative censoring and genuine temporal changes in risk, and propose practical ways to detect it. In simulations, we show that administrative-cutoff leakage can inflate fixed-horizon AUC and can also affect Harrell's C-index under realistic follow-up patterns. We then demonstrate the same behavior in a real mammography cohort. These results motivate a simple design principle for survival prediction: for an n-year prediction task, the dataset should provide at least n years of potential follow-up after the latest input date. Otherwise, the models may be subject to bias induced by administrative-cutoff leakage.

Survival analysis on Whole Slide Images (WSIs) is important in computational pathology for prognosis estimation and treatment planning. However, existing survival models are typically trained independently for each cancer cohort, making continual adaptation computationally expensive for gigapixel-scale WSIs. In this study, we propose MergeSurv, a merging-based continual learning framework for WSI survival analysis. A pathology vision-language foundation model is independently fine-tuned on each task, and the learned parameters are sequentially merged into a unified model without storing previous training data. We further investigate two inference strategies: One-for-All (OFA) and Voting-Expert Aggregation (VEA). Experiments on four TCGA cohorts demonstrate that MergeSurv outperforms naive fine-tuning as well as representative regularization-based and rehearsal-based continual learning methods, while effectively reducing catastrophic forgetting. The results suggest that model merging is a promising direction for scalable and privacy-preserving continual learning in computational pathology.

Genomic prediction models often fail to transfer across institutions because sequencing panels differ across sites, creating structural feature missingness at deployment. Existing approaches to this challenge typically restrict analysis to genes shared across cohorts, exclude patients with incomplete profiles, or rely on test-time imputation, all of which can reduce robustness and limit the use of multi-center data. We propose Survival prediction Handling Incomplete Features using Transformer (SHIFT), a missingness-aware survival model that directly predicts from incomplete genomic inputs without test-time imputation. SHIFT represents each genomic feature separately and uses masked self-attention, along with a feature-availability mask, so that predictions are based only on observed inputs. Further, we introduce variable-rate feature masking during training to improve robustness to heterogeneous missingness patterns. We evaluate the approach on glioblastoma and lung squamous cell carcinoma with external validation across multiple cohorts, including a challenging setting with severe cross-cohort panel mismatch. Across these settings, SHIFT shows strong generalization and compares favorably with standard survival baselines and imputation-based approaches, while using a single model across differing feature sets. We also find that incorporating patients from incomplete cohorts during development can improve performance on external data, suggesting that partially observed cohorts need not be excluded from model building. These results support missingness-aware modeling as a practical strategy for multi-center survival prediction in precision oncology.

Survival analysis models time-to-event data, but in clinical settings training data are costly and scarce: events accrue over years of follow-up, cohorts are small, and privacy regulations restrict sharing across institutions. Tabular generative models promise augmentation and privacy-preserving cohort sharing, yet are themselves data-hungry -- on the small cohorts typical of survival analysis, a single generator rarely characterizes the population well enough for downstream models trained on its output to match real-data performance. FoGS (Filtered Mixture-of-Generators for Survival analysis) reframes synthetic-data construction as sample selection rather than generation. A candidate pool is drawn from four architecturally distinct tabular generators, and each sample is scored by an ensemble of seven survival models trained on real data, using proper scoring rules as a per-sample plausibility proxy. A two-level pipeline optimizes, in its outer loop, a selection policy -- generator quotas, scorer weights, a random complement, and stratified balancing on event time and censoring -- against held-out downstream performance, while an inner loop tunes the downstream model (XGBoost-Cox). On 16 public datasets under train-on-synthetic, test-on-real (C-index and IBS, $0$--$100$ scale), FoGS yields mean improvements of $+2.17$ in C-index and $+0.67$ in IBS, improving both metrics on 9 of 16 datasets and at least one on 13 (one-sided Wilcoxon $p=0.039$ and $p=0.035$). It matches or exceeds real-data training on most cohorts, with no significant change in nearest-neighbour privacy margin relative to unfiltered sampling. Sample filtering over a heterogeneous generator pool is thus a viable substitute for real-data training in privacy-restricted clinical settings.

Survival analysis is central to clinical decision-making, yet reliable time-to-event models require large, diverse cohorts that are rarely available at a single institution, while privacy regulations restrict the centralization of patient data. Federated learning (FL) offers a privacy-preserving alternative by training shared models without exchanging raw data, but its effectiveness for survival modeling under realistic, heterogeneous conditions remains insufficiently understood. This paper presents a systematic, multi-model evaluation of federated survival analysis on a cross-institutional breast cancer cohort with naturally heterogeneous distributed clients. Three representative survival models, the Cox Proportional Hazards model, DeepSurv, and Random Survival Forest (RSF), are compared across centralized, local, and federated training, and three federated optimization strategies (FedAvg, FedProx, and FedAdam) are assessed for the gradient-based models. Results show that FL consistently outperforms local training and approaches, and occasionally exceeds, centralized performance, while RSF offers the best overall balance of discrimination, calibration, and robustness across heterogeneous clients. We further find that performance depends on the diversity of client distributions, and that FedAvg and FedProx are stronger and more stable than FedAdam. Based on these findings, we derive practical, decision-oriented guidelines mapping data, privacy, interpretability, and resource constraints to recommended model and training-paradigm choices for federated survival modeling in healthcare.

Generating a diverse set of high quality solutions for an optimisation problem has been studied extensively in recent years by the evolutionary computation community. A paradigm that has received increasing attention is evolutionary diversity optimisation (EDO), where the goal is to maximise the diversity of a solution set subject to quality constraints. Since the contribution of each solution to the diversity of the population depends on other solutions and can change dramatically if several solutions in the population are modified simultaneously, most EDO approaches generate a single new solution per generation and discard the solution with the least contribution to diversity, ensuring a steady increase in population diversity over successive generations until convergence. In this study, we aim to answer two questions: (1) Is generating multiple solutions in each generation beneficial for EDO? (2) How can this be achieved efficiently, given that conventional survival selection methods do not work well in EDO due to the dependency of a solution's contribution to diversity on other solutions?

Whole-slide images (WSIs) are widely used for computational cancer prognosis. However, most existing methods primarily focus on in-domain performance and fail to generalize across clinical centers. This limitation stems from their reliance on pixel-derived representations that are highly susceptible to domain-specific artifacts caused by staining protocols and scanner hardware. We hypothesize that high-level pathology semantics, such as tumor grade and micro-environmental architecture, provide a domain-invariant semantic representation that mirrors the robust diagnostic logic of human pathologists. Therefore, we propose a Semantic-Anchored Evidential Fusion Survival (SAEFS) framework, where SAEFS derives semantic anchors from WSIs via Visual Question Answering (VQA), employs a dual-stream WSI evidence extraction architecture, uses Dirichlet-based Subjective Logic to model uncertainty, and fuses semantic and visual evidence through a cautious conjunction rule to avoid overconfident fusion from correlated sources. Trained exclusively on one source domain and evaluated zero-shot across four unseen domains, SAEFS consistently outperforms state-of-the-art models both in prediction accuracy and reliability, improving the average C-index by 10.2%. Quantitative analyses further show that VQA-derived semantic features exhibit significantly lower cross-center divergence than pixel-derived features, highlighting their robustness for cross-center clinical applications.

Alzheimer's Disease (AD) is a complex neurodegenerative disorder that continues to impact millions of people worldwide. Predicting AD conversion during the prodromal stage remains critical for disease understanding and patient care. As such, survival models are widely used for AD risk prediction, yet they are typically static predictors with limited interpretability and no capacity for natural language reasoning. In this work, we propose iLENS, an interpretable large language model (LLM) guided framework based on mixture-of-experts (MoE) for survival prediction in AD conversion. Our approach uses LLM to synthesize structured neuroimaging measurements and unstructured information to guide expert routing. Our framework demonstrates competitive predictive performance and capability in patient subtyping. Furthermore, our framework provides transparent, biologically grounded rationales for its routing decisions, bridging the gap between high-performance survival analysis and interpretable clinical decision support.

Survival prediction plays a central role for healthcare providers and clinical researchers. Accurate risk stratification enables early intervention and improved patient management. Most existing deep survival models learn one common feature representation for all patients, which may hide important differences between patient subgroups. In contrast, a Mixture-of-Experts (MoE) framework allows different parts of the model to focus on different patient patterns, leading to more individualized representations. Therefore, in this work, we propose a mixture-of-experts enhanced adaptive deep clustering survival framework (AdaCSM) for modeling such heterogeneous survival patterns. We introduce a routing-based expert mechanism that enables conditional specialization within a parametric survival modeling framework. The proposed architecture allocates patients to specialized risk predictors dynamically while preserving the patient survival and subtype clustering objectives. We compare our method with state-of-the-art survival and deep clustering models on multiple real-world longitudinal clinical cohorts spanning diverse disease domains. The proposed method demonstrates improved predictive performance and leads to interpretable results in survival analysis.

Accurate prediction of overall survival (OS) from positron emission tomography/computed tomography (PET/CT) can support personalized treatment and follow-up strategies in oncology. However, the impact of temporal modeling on imaging-based survival prediction remains insufficiently explored. We investigate how different temporal formulations influence survival prediction by developing two complementary approaches: Attention-guided Time-Conditioned Survival (ATCS) and Multi-Time Survival (MTS). We retrospectively analyzed pre-treatment PET/CT images from 848 patients with non-small cell lung cancer (NSCLC), including 556 for model development and 292 for held-out testing. A previously proposed Time-Conditioned Survival (TCS) model was used as a baseline. Models were trained using 5-fold cross-validation and evaluated on the test set using time-dependent area under the curve (AUC) at 6-month intervals from 0.5 to 5 years. Both ATCS and MTS outperformed the baseline TCS model, achieving mean AUCs of 0.794 and 0.793, respectively, compared to 0.767. ATCS performed better at earlier time points (0.5-3 years), whereas MTS performed better at later intervals (3.5-5 years). Combining tumor-specific and tissue-wise PET/CT features improved performance over either input alone. Finer temporal discretization improved short-term prediction, while coarser intervals provided more stable long-term estimates. These findings demonstrate that temporal modeling and input design influence PET/CT-based survival prediction. The proposed approaches enable time-specific survival estimation from pre-treatment imaging and may support improved risk stratification and clinical decision-making.

Predicting time-to-event outcomes such as mortality is a fundamental task in clinical decision-making, commonly addressed through survival analysis. While classical statistical and deep learning approaches have been widely studied, they typically require task-specific training and sufficient labeled data. Recent advances in tabular foundation models offer a new paradigm by learning general-purpose representations for structured data. However, their applicability to censored time-to-event prediction in clinical settings remains underexplored, as typical applications are restricted to discrete classification rather than survival analysis tasks. In this work, we propose a lightweight adaptation approach for applying tabular foundation models to clinical survival analysis by directly training a survival-aware head on top of the pretrained representations. We study representative architectures, including TabPFN, TabDPT, and TabICL, and adapt them using a multi-task logistic regression (MTLR) head to model right-censored time-to-event outcomes. We evaluate this approach on a diverse set of public survival benchmarks and two large-scale ICU cohorts, MIMIC-IV and eICU. Our results show that this transfer learning approach achieves competitive or superior performance compared to strong baselines. On MIMIC-IV, TabDPT-FT-MTLR reaches a C-index of 0.856, corresponding to a relative improvement of +1.4% over the best non-FM baseline (DeepSurv, 0.844) and +6.7% over the best zero-shot model (0.802). On eICU, TabICL-FT-MTLR achieves 0.797, yielding gains of +1.7% (DeepSurv, 0.784) and +6.4% (0.749), respectively. These findings highlight the importance of combining pretrained tabular representations with survival-aware objectives and suggest that tabular foundation models provide a practical and effective alternative for clinical survival prediction.

Persistence diagrams are common representations in topological data analysis, but they do not naturally live in a vector space, and the statistical tools developed for comparing them have largely evolved separately from those used for downstream prediction. We introduce STRAND (Survival Topological Representation ANalysis of Diagrams), which treats (collections of) PDs as survival data: each topological feature with persistence value $p = d - b$ is a fully observed time-to-event, and the persistence survival function $S(t) = \mathbb{P}(p > t)$ is the central object for comparing diagrams. From this single representation we derive (i) a non-parametric two-sample test with calibrated Type I error and high power from a small number of diagrams; (ii) interpretable effect sizes; and (iii) a 1-Wasserstein-stable feature vector for downstream machine learning. We validate calibration and power on synthetic manifolds with controlled topology, demonstrate competitive vectorisation across 14 graph and 3D point cloud benchmarks, and apply the method to study functional brain connectivity in fMRI/neuroscience data. To our knowledge, STRAND is the first method to provide hypothesis testing and vectorisation for persistence diagrams from a single coherent and interpretable representation.

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.

We investigate whether information about time-to-event risk estimated by a Cox proportional hazards model can be transferred into a generative large language model. We propose a text-based survival modelling pipeline in which structured clinical covariates are converted into text prompts and a Qwen-based large language model is fine-tuned to generate patient-specific survival risk using Cox model predictions as a training target. Across GBSG2, ACTG320, and WHAS500, the model achieves competitive held-out discrimination and calibration despite being trained as a text-generation task rather than with a conventional survival-analysis loss. We further analyse the geometry of the model's hidden states, where t-SNE visualisations reveal smooth risk gradients in latent space, suggesting that the model represents survival risk as a continuous structure rather than isolated risk categories. Together, these findings suggest that large language models can internalise survival-risk structure while supporting calibrated prediction, providing a route towards time-to-event reasoning in language models.

Modern medicine relies on heterogeneous data sources spanning radiology, pathology, text reports, and structured clinical information. However, real-world patient data are frequently incomplete, with missing or sparsely acquired modalities, limiting the effectiveness of standard multimodal fusion approaches. To this end, we propose the Multimodal Flexible Redundancy-aware decomposed GAted Learning (Multi-FRuGaL) framework, a decomposition-aware, adaptive gated intermediate-fusion framework that performs modality-level representation learning under missing data. Multi-FRuGaL integrates per-modality encoders with a signal decomposition layer, an input-conditioned gating network, and an information-aware fusion objective to separate redundant from modality-specific complementary signals, selectively upweighting informative modalities and suppressing redundant or noisy inputs, and remaining well-defined even when multiple modalities are absent. We evaluate Multi-FRuGaL on two multimodal head and neck cancer cohorts: the HANCOCK challenge dataset (N = 763) comprising five modalities and two prognostic endpoints (5-year survival and 2-year recurrence), and the HECKTOR challenge dataset (N = 588) comprising three modalities for human papillomavirus (HPV) status classification. Multi-FRuGaL consistently achieves higher mean performance than the evaluated baselines across multiple tasks, improving AUC from 0.601 to 0.8496 for survival, from 0.672 to 0.8102 for recurrence, and achieving 0.975 AUC for HPV prediction on HECKTOR. For survival analysis, it further achieves a concordance index of 0.6814 for overall survival, 0.7421 for recurrence-free survival, and 0.7143 for progression-free survival on HANCOCK, and 0.7203 for recurrence-free survival on HECKTOR. Qualitative analyses further show that Multi-FRuGaL learns discriminative and robust multimodal representations, even under severe missing-modality conditions.

Proper scoring rules provide a rigorous theoretical basis for the training and evaluation of probabilistic forecasts. However, in the presence of right censoring, the event time is only partially observed, rendering conventional scoring rules inapplicable in their standard form. We propose a framework for proper scoring of right-censored survival outcomes based on a simple idea: first, map the predictive distribution through the censoring mechanism, then apply the underlying proper score on the induced observed-data law. This yields localized scores for fixed censoring times and marginalized scores when the censoring time is random or only partially observed. The resulting construction recovers familiar right-censored likelihood and IPCW-type criteria within a coherent framework, while also yielding right-censored versions of the CRPS, pinball loss, Brier score, and energy score. We show that the marginalized score is proper under conditional independent censoring and strictly proper on the identifiable region. The same principle also leads to censored engression, a sample-based learning objective for multivariate right-censored survival modeling. In experiments, our scores correctly rank the oracle forecast across several censoring regimes, whereas forecast-dependent plug-in weighted scores can exhibit ranking reversals. Censored engression likewise substantially improves over naive training on censored outcomes.

Tabular foundation models (TFMs) have made rapid progress in standard classification and regression, but time-to-event survival prediction tasks have remained largely untouched. Unlike in standard regression tasks, survival prediction models must account for censored data. Standard TFMs cannot handle natively censored data, leading to biased and inaccurate predictions, making them unsuitable for real-world applications. To overcome this fundamental limitation, we propose \texttt{SurvPFN}, a prior-data fitted network (PFN), for survival prediction tasks. We pretrain \texttt{SurvPFN} on millions of synthetic survival prediction tasks to learn survival via distributional regression that accounts for censored data. \texttt{SurvPFN} works by (1) generating data with Weibull event times and a non-informative censoring mechanism; (2) integrating a censored event indicator; and (3) minimizing a censored negative log-likelihood. On SurvSet, a collection of real-world survival tasks, \texttt{SurvPFN} is highly competitive with classical and deep survival baselines without per-dataset fitting, a survival-specific architecture, or feature engineering. We show that survival can be treated as a continuous-time distributional regression problem with censored loss, unlocking the power of PFNs for time-to-event predictions.

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.

Machine learning predictors have become essential tools for guiding automated decision making. However, a major misalignment persists: predictive models are typically optimized in terms of standard statistical metrics in isolation from the algorithmic tasks they inform. We highlight this incongruity in the high-stakes domain of organ allocation by demonstrating that any algorithm relying on (even highly accurate) survival predictors optimized for standard metrics -- such as the Concordance index (C-index) -- can yield arbitrarily poor outcomes when used for allocation, failing to guarantee utility better than a uniform random selection. To bridge the gap between survival analysis and policy optimization, we introduce a decision-focused learning approach based on optimizing normalized discounted cumulative gain (NDCG), a mainstay metric in information retrieval. We establish the utility of NDCG in survival analysis by proving that it translates to guarantees on the performance of allocation. Empirically, we propose a bootstrapping approach to optimize the NDCG of existing survival models. Unlike prior work, we also address the challenge of right censorship when evaluating ranking. On historical heart transplant data from the US, our method dramatically boosts the NDCG of baseline models by 50-100%, which translates to tens of thousands of additional life years gained annually when deployed for transplant allocation. We anticipate that our framework will find broader applications in decision making with predictions.

Estimating the causal effect of time-varying treatments on survival outcomes in large observational studies is computationally demanding, particularly when outcomes are rare. While g-formula-based methods such as the iterative conditional expectation (ICE) estimator provide a principled framework for longitudinal causal inference, they become computationally expensive, especially when bootstrap-based variance estimation is required. In addition, outcome rarity at each time point induces severe class imbalance, leading to instability and convergence issues in logistic regression and related models. To address these challenges, we propose a principled subsampling and reweighting strategy for longitudinal survival data that can be applied to a range of existing causal effect estimators in this setting, including the ICE estimator. The proposed method substantially reduces computational burden while preserving consistency and improving estimation stability in rare-outcome settings. We evaluate the method through simulations and validate it using a large-scale EHR cohort study on social and behavioral determinants of health (SBDH) and suicide risk, demonstrating its effectiveness for modeling rare outcomes in longitudinal data.

A mobile robot following a graph of known routes can make costly navigation errors when a temporary obstacle blocks a critical edge: waiting too long behind a parked cart wastes time, but immediately rerouting around a person who would move in a few seconds is also inefficient. Standard reactive obstacle avoidance addresses local motion around obstacles, while fixed wait-or-reroute rules ignore how long different obstacle types tend to persist. We propose OSCAR: an adaptive survival-modeling framework for graph-based navigation with temporary blockages. Assuming obstacle class labels are available at encounter time, the robot learns class-conditioned residual clearance-time distributions from online experience, including right-censored observations when it reroutes before observing clearance. These survival models are integrated into a time-dependent graph planner that maintains obstacle memory and computes a patience threshold at each blocked edge: how long to wait before taking an alternate route. The method continuously updates its clearance estimates across episodes and uses them to balance waiting against rerouting. We evaluate the approach in simulation and on a real mobile robot in a university atrium with obstacles including people, chairs, bins, and tubes. In simulation, the learned policy's time-to-goal converges to within 1% of an oracle with access to ground-truth clearance distributions after fewer than 20 observations per obstacle class, outperforming all heuristic baselines. Real-world deployment confirms that the policy improves online, adapting its patience thresholds from experience across 50 navigation episodes.

Survival analysis concerns the task of predicting the time until an event occurs. Often used in the medical field, survival analysis deals with incomplete (i.e., censored) data, for instance, from patients who did not experience the event during the duration of the study. For practical use, both accuracy and interpretability are important. Survival trees are easy-to-follow survival models that split the patient cohort recursively into discrete patient groups. Whilst survival trees can capture complex relationships, they typically need to grow large, threatening interpretability. Moreover, survival trees are often built using greedy approaches that may overlook globally optimal split combinations, limiting predictive performance. Shallow survival trees require expressive, higher-order feature combinations to achieve competitive accuracy. We therefore use genetic programming to multi-objectively evolve inherently inspectable feature sets and study how they interact with different tree induction strategies. We further introduce an evolutionary approach that jointly optimises the survival tree structure and the non-linear split logic. Our findings demonstrate that evolutionary feature construction improves predictive performance across different tree induction strategies on two real-world datasets and two different survival tree depths. Given its speed and flexible presentation, the multi-objective evolution of entire trees likely holds the most future promise.

In randomized trials involving multiple treatments, bivariate survival outcomes present significant analytical challenges for making decisions. This paper addresses the problem of deriving optimal individualized treatment rules to maximize the joint survival probability beyond fixed time points $(t_1, t_2)$ through deep neural networks, while accounting for right censoring. We propose a novel approach that models treatment rules via stochastic policies, coupling marginal accelerated failure time models via link function to capture bivariate dependence. To enhance robustness and effectiveness of decision making, we introduce an adaptive prediction-powered method that leverages auxiliary predictions from machine learning models.

Objective: Survival analysis is central to medical prediction, yet large language models (LLMs) are rarely used as end-to-end survival models because censoring prevents straightforward supervised fine-tuning. Here we present LLMSurvival, a framework that enables censoring-aware survival analysis with unmodified LLMs operating directly on tabular clinical data. Materials and Methods: LLMSurvival reformulates time-to-event prediction as pairwise ranking among comparable subjects, and derives test-time risk by aggregating comparisons against anchor individuals from the training cohort. Results: Across two clinical tasks (ICU mortality prediction in MIMIC-IV and fragility fracture prediction in a NewYork-Presbyterian/Weill Cornell Medicine cohort), LLMSurvival improves overall concordance over Cox proportional hazards modeling by 3.1% for ICU mortality and 0.5% for fracture risk, 2.1% on average for ICU mortality and 2.8% for fracture risk over three established deep learning survival models. Discussion: The results show that survival modeling with censoring can be made compatible with LLM fine-tuning through comparison-based reformulation. The framework demonstrates high portability and superior performance over expert curated scores like SAPS-II and FRAX scores across diverse clinical context. Furthermore, the framework supports local deployment, as compact, publicly available base models provide sufficient performance. Conclusion: The LLMSurvival framework serves as a proof of concept for an integrated, censoring-conscious approach to survival analysis via LLMs.

In computational pathology, Whole Slide Images (WSIs) survival analysis is crucial for patient prognosis assessment, but it faces multiple technical challenges. Although the Transformer captures long-range dependencies through its self-attention mechanism, its $O(N^2)$ time complexity causes a severe computational bottleneck in large-scale WSIs graph structures. The Mamba model breaks through the Transformer's computational bottleneck with linear complexity. But, owing to Mamba's high sensitivity to the order of input data, traditional node sorting methods in Graph Mamba, such as those based on node degree or subgraph size, fail to adequately account for the topological connectivity of graph data. This inadequacy consequently restricts the performance of Mamba's sequential modeling. Moreover, its unidirectional architecture cannot leverage the bidirectional spatial structure of images. To address these challenges, this paper proposes a novel Graph Mamba survival analysis framework based on topology-aware ordering (TopoMamSurv) to adapt to the sequential sensitivity of Mamba. Our visualization experiments further confirmed that the nodes extracted through the topology-aware ordering (TAO) strategy indeed exhibit higher similarity. Furthermore, we designed a bidirectional Mamba module and integrated a Graph Convolutional Network (GCN) to achieve bidirectional spatial context modeling of images, forming a hierarchical feature learning architecture for "local aggregation - global capture." This framework effectively reconciles the contradiction between long-range dependency modeling, computational efficiency, and spatial structure utilization in WSIs analysis through its systematic design of TAO, bidirectional semantic modeling, and hierarchical feature fusion. This framework has been validated for its comprehensive performance advantage on five TCGA datasets.

No existing nested Archimedean copula tool handles all three of (a) arbitrary per-variable (right-)censoring in survival analysis, (b) arbitrary nesting trees, and (c) exact parameter gradients. Existing implementations handle only bivariate problems, low dimensional (i.e., $d \leq 10$) cases, two layers of nesting, or only hand-derived copula nestings. We present \textsc{acopula}, a JAX-native framework that, given any Archimedean generator -- classical or neural -- evaluates exact nested-copula likelihoods and parameter gradients under arbitrary censoring masks in polynomial time. The mechanism is polynomial powering of Taylor-mode automatic differentiation output, which replaces per-family hand-derived partial Bell polynomial tables with a single differentiable computation that any user-defined generator can drive. We conduct extensive simulations to verify the correctness of \textsc{acopula}. We then demonstrate (a) per-variable censoring on $85{,}229$ MIMIC-IV ICU admissions in high dimensions with $d{=}53$, fit by both classical Archimedean families and nested neural Archimedean copulas; (b) an 11-sector hierarchical model on S&P~500 daily returns at $d{=}98$; (c) family-agnostic censored MLE across ten families, five of them with no prior implementation, on a retinopathy study; and (d) a ${\sim}650\times$ per-density speedup over R's \texttt{nacLL} at $d{=}35$, scaling quadratically to $d{=}8{,}000$.

Survival analysis aims to model how covariates and time jointly shape the time-to-event distribution under right censoring. Classical methods such as the Cox model and generalised additive models (GAMs) require interactions and time-varying effects to be manually specified, which is increasingly impractical on rich clinical datasets. We introduce KAPLAN-HR, a B-spline Kolmogorov-Arnold Network (KAN) for nonparametric estimation of the conditional hazard as a joint function of covariates and time. A single-layer KAPLAN-HR model recovers a GAM, while deeper architectures capture interactions and time-varying effects through composition. We establish a convergence rate for the nonparametric KAN hazard estimator that depends only on the smoothness of the underlying KAN representation and not on the covariate dimension, thereby mitigating the curse of dimensionality for KAN-representable targets. In evaluations over six clinical benchmark datasets, KAPLAN-HR matches or exceeds the predictive performance of established statistical and deep learning survival methods.

Survival analysis aims to estimate a time-to-event distribution from data with censored observations. Many existing methods either impose structural assumptions on the hazard function or discretize the time axis, which may limit flexibility and introduce approximation errors. We propose the Survival Diffusion Probabilistic Model (SDPM), a generative approach to continuous-time survival analysis. SDPM models the conditional distribution of the survival outcome, represented by the pair of observed time and censoring indicator, $\mathbb{P}(T,δ\mid \mathbf{x})$, using a denoising diffusion model. Under the assumption of conditionally independent censoring, conditional samples generated by the model can be transformed into survival function estimates using the Kaplan-Meier estimator. This formulation avoids parametric assumptions on the event-time distribution and does not require a discretization of the output time space. The model operates in a transformed target space, using standardized log-times and a continuous Gaussian-mixture representation of the censoring indicator. We evaluate SDPM on ten real survival datasets and compare it with five strong baselines, including tree-based, boosting-based, and neural survival models. Results show that SDPM achieves competitive predictive performance across C-index, integrated time-dependent AUC, and integrated Brier score. A study on synthetic Cox-Weibull data demonstrates that SDPM can recover the shape of an underlying continuous survival distribution more accurately than a strong nonparametric baseline when sufficiently many samples are generated. An ablation study confirms the importance of the proposed target-space transformations, which improve event-rate calibration, reduce invalid generated times, and provide consistent gains in predictive discrimination. Codes implementing the proposed model are publicly available.

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.

Time-to-event data is widespread across the life sciences and engineering, but it is typically encountered together with censoring, which complicates the application of standard machine learning methods. Deep Cox models have emerged as a popular method for analyzing time-to-event data because they gracefully handle censoring and can be used with unstructured data such as clinical text reports, genomic sequences, and pathology images. However, their predicted survival probabilities are often poorly calibrated, thus limiting their practical utility. In this paper, we propose a novel post hoc calibration method for Deep Cox models that uses isotonic regression to refine predicted survival probabilities without affecting discriminative power. We establish favorable theoretical guarantees, including a double-robustness property and asymptotic calibration. Experiments on synthetic and real-world clinical data demonstrate the empirical effectiveness of our method.

Flexible continuous-time survival modeling is critical for capturing complex time-varying hazard dynamics in high-dimensional data; however, training such models remains challenging due to the intractable integral required for likelihood estimation. We introduce QSurv, a scalable deep learning framework that enables nonparametric continuous-time modeling without relying on time discretization or restrictive distributional assumptions. We propose a training objective based on Gauss-Legendre numerical quadrature, which approximates the cumulative hazard with high-order accuracy while facilitating efficient end-to-end training via standard backpropagation. Furthermore, to effectively capture non-stationary hazard dynamics in complex architectures, we introduce time-conditioned low-rank adaptation, a mechanism that conditions general neural backbones on time by dynamically modulating weights via low-rank updates. We provide theoretical analysis establishing approximation error bounds for cumulative-hazard evaluation. Comprehensive experiments across synthetic benchmarks, large-scale real-world tabular datasets, and high-dimensional medical imaging tasks demonstrate that QSurv achieves competitive predictive performance with advantages in instantaneous hazard function estimation, enabling more interpretable characterization of time-varying risk patterns.

Survival analysis provides a powerful statistical framework for modeling time-to-event outcomes in the presence of censoring. However, selecting an appropriate estimator from the many specialized survival approaches often requires substantial methodological and domain expertise. We introduce SurvivalPFN, a prior-data fitted network that amortizes Bayesian inference for censored observations through in-context learning. SurvivalPFN is pretrained on a diverse family of synthetic, identifiable, and right-censored data-generating processes, enabling it to amortize survival analysis in a single forward pass during inference. As a result, the model adapts to the effective complexity of each dataset without task-specific training or hyperparameter tuning, avoids restrictive parametric assumptions, and produces calibrated survival distributions. In a large-scale benchmark spanning 61 datasets, 21 methods, and 5 evaluation metrics, SurvivalPFN achieves strong predictive performance and often improves upon established survival models. These results suggest that SurvivalPFN offers a principled and practical foundation model for survival analysis, with potential applications in high-impact domains such as healthcare, finance, and engineering (https://github.com/rgklab/SurvivalPFN).

Large language models (LLMs) are increasingly deployed in a wide range of applications, yet remain vulnerable to adversarial jailbreak attacks that circumvent their safety guardrails. Existing evaluation frameworks typically report binary success/failure metrics, failing to capture the temporal dynamics of how attacks succeed under persistent adversarial pressure. This preliminary work proposes a novel evaluation framework that applies survival analysis techniques to characterize LLM jailbreak vuln`erability. Our approach models the time-to-jailbreak as a survival outcome, enabling estimation of hazard functions, survival curves, and risk factors associated with successful attacks. We evaluate three LLMs against a subset of prompts from the HarmBench dataset spanning three attack categories. Our analysis reveals that models exhibit distinct vulnerability profiles: while one model demonstrates rapid degradation under iterative attacks, the two other models show consistent moderate vulnerability. Our framework provides actionable insights for model and LLM application developers and establishes survival analysis as a rigorous methodology for LLM safety evaluation.

We propose a novel multimodal deep learning framework for patient-level survival prediction, which integrates whole-slide histology features, RNA-seq expression profiles, and clinical variables. Our architecture combines an ABMIL module~\cite{ilse2018attention} for slide-level representation with feedforward encoders for RNA and clinical data. These embeddings are then integrated through low-rank bilinear cross-modal fusion~\cite{liu2018efficient} to model conditional interactions across modalities while controlling parameter growth. The model outputs continuous risk scores that are subsequently mapped to survival times using a nonparametric calibration procedure based on the Kaplan--Meier estimator~\cite{kaplan1958nonparametric}. By decomposing multimodal reasoning into independent pairwise interactions, the proposed fusion design promotes structural interpretability and parameter efficiency compared with full tensor and hierarchical fusion strategies. Experiments on the CHIMERA challenge dataset demonstrate improved predictive performance over concatenation-based baselines and competitive generalization on hidden evaluation cohorts. These results indicate that the proposed framework is a promising approach for multimodal survival prediction in HR-NMIBC. The implementation is publicly available at https://github.com/hassancpu/ChimeraChallenge2025_Task_3.

In the data-driven era, large-scale datasets are routinely collected and analyzed using machine learning (ML) and artificial intelligence (AI) to inform decisions in high-stakes domains such as healthcare, employment, and criminal justice, raising concerns about the fairness behavior of these systems. Existing works in fair ML cover tasks such as bias detection, fair prediction, and fair decision-making, but largely focus on static settings. At the same time, fairness in temporal contexts, particularly survival/time-to-event (TTE) analysis, remains relatively underexplored, with current approaches to fair survival analysis adopting statistical fairness definitions, which, even with unlimited data, cannot disentangle the causal mechanisms that generate disparities. To address this gap, we develop a causal framework for fairness in TTE analysis, enabling the decomposition of disparities in survival into contributions from direct, indirect, and spurious pathways. This provides a human-understandable explanation of why disparities arise and how they evolve over time. Our non-parametric approach proceeds in four steps: (1) formalizing the necessary assumptions about censoring and lack of confounding using a graphical model; (2) recovering the conditional survival function given covariates; (3) applying the Causal Reduction Theorem to reframe the problem in a form amenable to causal pathway decomposition; (4) estimating the effects efficiently. Finally, our approach is used to analyze the temporal evolution of racial disparities in outcome after admission to an intensive care unit (ICU).

We propose non-parametric estimators for the average run length (ARL) and average detection delay (ADD) in quickest changepoint detection (QCD) under finite and irregular sequence lengths. Although ARL and ADD are widely used as optimality criteria in theoretical and simulation studies, their application to real-world datasets is hindered by limited and irregular sequence lengths. To address this issue, we propose non-parametric estimators for the ARL and ADD, termed KM-ARL and KM-ADD, by drawing an analogy between QCD and survival analysis to model detection probabilities under sequence truncation. We derive estimation bias bounds and prove that they are asymptotically unbiased unless extrapolation is required. Experiments on simulated and real-world datasets demonstrate their practical utility, enhancing robustness against limited and irregular sequence lengths, improving interpretability, and facilitating empirical, intuitive model selection. Our Python code is provided at https://github.com/TaikiMiyagawa/Kaplan-Meier-Average-Run-Length, offering ready-to-use implementations for practitioners.

Survival analysis on tabular data is a well-studied problem. However, existing deep learning methods are often highly task-specific, which can limit the transfer of new approaches from other domains and introduce constraints that may affect performance. We propose TabSurv, an approach that adapts modern tabular architectures to survival analysis using either the Weibull distribution or non-parametric survival prediction. TabSurv optimizes SurvHL, a novel histogram loss function supporting censored data. In addition to a baseline feed-forward network, we implement deep ensembles of MLPs for survival analysis within TabSurv. In contrast to prior work, the ensemble components are trained in parallel, optimizing survival distribution parameters before averaging, which promotes diversity across ensemble component predictions. We perform a comprehensive empirical evaluation of different proposed architectures on 10 diverse real-world survival datasets. Our results show that TabSurv consistently outperforms on average established classical and deep learning baselines, such as RSF, DeepSurv, DeepHit, SurvTRACE. Notably, deep ensembles with Weibull parametrization instead of non-parametric models achieve the highest average rank by C-index. Overall, our study clarifies how modern tabular neural networks can be adapted and trained to tackle survival analysis problems, offering a strong and reliable approach. The TabSurv implementation is publicly available.

Pathology foundation models (PFMs) have recently emerged as powerful pretrained encoders for computational pathology, enabling transfer learning across a wide range of downstream tasks. However, systematic comparisons of these models for clinically meaningful prediction problems remain limited, especially in the context of survival prediction under external validation. In this study, we benchmark widely used and recently proposed PFMs for breast cancer survival prediction from whole-slide histopathology images. Using a standardized pipeline based on patch-level feature extraction and a unified survival modeling framework, we evaluate model representations across three independent clinical cohorts comprising more than 5,400 patients with long-term follow-up. Models are trained on one cohort and evaluated on two independent external cohorts, enabling a rigorous assessment of cross-dataset generalization. Overall, H-optimus-1 achieves the strongest survival prediction performance. More broadly, we observe consistent generational improvements across model families, with second-generation PFMs outperforming their first-generation counterparts. However, absolute performance differences between many recent PFMs remain modest, suggesting diminishing returns from further scaling of pretraining data or model size alone. Notably, the compact distilled model H0-mini slightly outperforms its larger teacher model H-optimus-0, despite using fewer than 8% of the parameters and enabling significantly faster feature extraction. Together, these results provide the first large-scale, externally validated benchmark of PFMs for breast cancer survival prediction, and offer practical guidance for efficient deployment of PFMs in clinical workflows.

Survival analysis is a widely used statistical framework for modeling time-to-event data under censoring. Classical methods, such as the Cox proportional hazards (Cox PH) model, offer a semiparametric approach to estimating the effects of covariates on the hazard function. Despite its importance, survival analysis has been largely unexplored in online settings, particularly within the bandit framework, where decisions must be made sequentially to optimize treatments as new data arrive over time. In this work, we take an initial step toward integrating survival analysis into a purely online learning setting under the Cox PH model, addressing key challenges including staggered entry, delayed feedback, and right censoring. We adapt three canonical bandit algorithms to balance exploration and exploitation, with theoretical guarantees of sublinear regret bounds. Extensive simulations and semi-real experiments using SEER cancer data demonstrate that our approach enables rapid and effective learning of near-optimal treatment policies.

Decentralized Finance (DeFi) lending protocols like Aave v3 rely on over-collateralization to secure loans, yet users frequently face liquidation due to volatile market conditions. Existing risk management tools utilize static health-factor thresholds, which are reactive and fail to distinguish between administrative "dust" cleanup and genuine insolvency. In this work, we propose an autonomous agent that leverages time-to-event (survival) analysis and moves beyond prediction to execution. Unlike passive risk signals, this agent perceives risk, simulates counterfactual futures, and executes protocol-faithful interventions to proactively prevent liquidations. We introduce a return period metric derived from a numerically stable XGBoost Cox proportional hazards model to normalize risk across transaction types, coupled with a volatility-adjusted trend score to filter transient market noise. To select optimal interventions, we implement a counterfactual optimization loop that simulates potential user actions to find the minimum capital required to mitigate risk. We validate our approach using a high-fidelity, protocol-faithful Aave v3 simulator on a cohort of 4,882 high-risk user profiles. The results demonstrate the agent's ability to prevent liquidations in imminent-risk scenarios where static rules fail, effectively "saving the unsavable" while maintaining a zero worsening rate, providing a critical safety guarantee often missing in autonomous financial agents. Furthermore, the system successfully differentiates between actionable financial risks and negligible dust events, optimizing capital efficiency where static rules fail.

In evolutionary reinforcement learning tasks (ERL), agent policies are often encoded as small artificial neural networks (NERL). Such representations lack explicit modular structure, limiting behavioral interpretation. We investigate whether programmatic policies (PERL), implemented as soft, differentiable decision lists (SDDL), can match the performance of NERL. To support reproducible evaluation, we provide the first fully specified and open-source reimplementation of the classic 1992 Artificial Life (ALife) ERL testbed. We conduct a rigorous survival analysis across 4000 independent trials utilizing Kaplan-Meier curves and Restricted Mean Survival Time (RMST) metrics absent in the original study. We find a statistically significant difference in survival probability between PERL and NERL. PERL agents survive on average 201.69 steps longer than NERL agents. Moreover, SDDL agents using learning alone (no evolution) survive on average 73.67 steps longer than neural agents using both learning and evaluation. These results demonstrate that programmatic policies can exceed the survival performance of neural policies in ALife.