DeepComp: Which Competing Event Will Hit the Patient First?

2020 
When taking care of complex patients with multiple morbidities, accurately predicting the occurrence of each cause-specific event is critical for designing optimal treatment plans. However, standard survival analysis cannot deal with the multiple (usually competing) adverse events and views those competing events as censored. This will result in biased estimation of the incidence rate. In this paper, we propose a deep learning based survival analysis algorithm called DeepComp to jointly predict the progress of the competing events, which can thus inform the doctors which event is more likely to hit the patient first. DeepComp constructs a multi-task recurrent neural network (RNN) and views the conditional probability of each competing event at each time point as the output of each RNN cell. Then the probability chain rule is utilized to combine them together. In this way, the survival probability and the risk for each competing event over the time space are obtained. The multitask structure not only prevents the model from unreasonable censoring but also aids the model in capturing the complex hidden association among the competing events. A novel penalty is added to the loss function to better discriminate the competing risks for each particular patient, which could benefit treatment decision-making. We conduct comprehensive experiments on two real-world clinical data sets and one synthetic data set. The proposed DeepComp method achieves significant performance improvement compared to the state-of-the-art baseline methods.
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