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Aug 20

CountsDiff: A Diffusion Model on the Natural Numbers for Generation and Imputation of Count-Based Data

Diffusion models have excelled at generative tasks for both continuous and token-based domains, but their application to discrete ordinal data remains underdeveloped. We present CountsDiff, a diffusion framework designed to model distributions on the natural numbers. CountsDiff extends the Blackout diffusion framework by simplifying its formulation through a direct parameterization in terms of a survival probability schedule and an explicit loss weighting. This introduces flexibility through design parameters with direct analogues in existing diffusion modeling frameworks. Beyond this reparameterization, CountsDiff introduces features from modern diffusion models, previously absent in counts-based domains, including continuous-time training, classifier-free guidance, and churn/remasking reverse dynamics that allow non-monotone reverse trajectories. We propose an initial instantiation of CountsDiff and validate it on natural image datasets (CIFAR-10, CelebA), exploring the effects of the introduced design parameters in a complex, well-studied, and interpretable data domain. We then highlight biological count assays as a natural use case, evaluating CountsDiff on single-cell RNA-seq imputation in fetal and heart cell atlases. Remarkably, we find that even this simple instantiation matches or surpasses the performance of a state-of-the-art discrete generative model and leading scRNA-seq imputation methods, while leaving substantial headroom for further gains through optimized design choices in future work.

  • 8 authors
·
Jun 3

A Flexible Parametric Modelling Framework for Survival Analysis

We introduce a general, flexible, parametric survival modelling framework which encompasses key shapes of hazard function (constant, increasing, decreasing, up-then-down, down-then-up), various common survival distributions (log-logistic, Burr type XII, Weibull, Gompertz), and includes defective distributions (i.e., cure models). This generality is achieved using four basic distributional parameters: two scale-type parameters and two shape parameters. Generalising to covariate dependence, the scale-type regression components correspond to accelerated failure time (AFT) and proportional hazards (PH) models. Therefore, this general formulation unifies the most popular survival models which allows us to consider the practical value of possible modelling choices for survival data. Furthermore, in line with our proposed flexible baseline distribution, we advocate the use of multi-parameter regression in which more than one distributional parameter depends on covariates - rather than the usual convention of having a single covariate-dependent (scale) parameter. While many choices are available, we suggest introducing covariates through just one or other of the two scale parameters, which covers AFT and PH models, in combination with a `power' shape parameter, which allows for more complex non-AFT/non-PH effects, while the other shape parameter remains covariate-independent, and handles automatic selection of the baseline distribution. We explore inferential issues in simulations, both with and without a covariate, with particular focus on evidence concerning the need, or otherwise, to include both AFT and PH parameters. We illustrate the efficacy of our modelling framework by investigating differences between treatment groups using data from a lung cancer study and a melanoma study. Censoring is accommodated throughout.

  • 3 authors
·
Jan 10, 2019

Cost-effectiveness analysis for therapy sequence in advanced cancer: A microsimulation approach with application to metastatic prostate cancer

Purpose. Patients with advanced cancer may undergo multiple lines of treatment, switching therapies as their disease progresses. Motivated by a study of metastatic prostate cancer, we develop a microsimulation framework to study therapy sequence. Methods. We propose a discrete-time state transition model to study two lines of anti-cancer therapy. Based on digitized published progression-free survival (PFS) and overall survival (OS) curves, we infer event types (progression or death), and estimate transition probabilities using cumulative incidence functions with competing risks. Our model incorporates within-patient dependence over time, such that response to first-line therapy informs subsequent event probabilities. Parameters governing the degree of within-patient dependence can be used to calibrate the model-based results to those of a target trial. We demonstrate these methods in a study of two therapy sequences for metastatic prostate cancer, where Docetaxel (DCT) and Abiraterone Acetate (AA) are both appropriate for use in either first or second line treatment. We assess costs, Quality-Adjusted Life Years (QALYs) and Incremental Cost Effectiveness Ratio (ICER) for two treatment strategies: DCT then AA vs AA then DCT. Results. Using digitized survival curves from relevant clinical trials, we identified 8.6-13.9% of PFS times that should be categorized as deaths, allowing for estimation of cumulative incidence functions. Models assuming within-patient independence overestimated OS time, corrected with our calibration approach. Correction resulted in meaningful changes in the difference in QALYs between treatment strategies (0.07 vs 0.15) and the ICER (-\76,836/QALY vs -21,030/QALY). Conclusions. Microsimulation models can be successfully used to study cost-effectiveness of therapy sequences, taking care to account correctly for within-patient dependence.

  • 5 authors
·
Oct 10, 2022

OncoReason: Structuring Clinical Reasoning in LLMs for Robust and Interpretable Survival Prediction

Predicting cancer treatment outcomes requires models that are both accurate and interpretable, particularly in the presence of heterogeneous clinical data. While large language models (LLMs) have shown strong performance in biomedical NLP, they often lack structured reasoning capabilities critical for high-stakes decision support. We present a unified, multi-task learning framework that aligns autoregressive LLMs with clinical reasoning for outcome prediction on the MSK-CHORD dataset. Our models are trained to jointly perform binary survival classification, continuous survival time regression, and natural language rationale generation. We evaluate three alignment strategies: (1) standard supervised fine-tuning (SFT), (2) SFT with Chain-of-Thought (CoT) prompting to elicit step-by-step reasoning, and (3) Group Relative Policy Optimization (GRPO), a reinforcement learning method that aligns model outputs to expert-derived reasoning trajectories. Experiments with LLaMa3-8B and Med42-8B backbones demonstrate that CoT prompting improves F1 by +6.0 and reduces MAE by 12%, while GRPO achieves state-of-the-art interpretability and predictive performance across BLEU, ROUGE, and BERTScore. We further show that existing biomedical LLMs often fail to produce valid reasoning traces due to architectural constraints. Our findings underscore the importance of reasoning-aware alignment in multi-task clinical modeling and set a new benchmark for interpretable, trustworthy LLMs in precision oncology.

  • 4 authors
·
Oct 20, 2025

Multimodal Optimal Transport-based Co-Attention Transformer with Global Structure Consistency for Survival Prediction

Survival prediction is a complicated ordinal regression task that aims to predict the ranking risk of death, which generally benefits from the integration of histology and genomic data. Despite the progress in joint learning from pathology and genomics, existing methods still suffer from challenging issues: 1) Due to the large size of pathological images, it is difficult to effectively represent the gigapixel whole slide images (WSIs). 2) Interactions within tumor microenvironment (TME) in histology are essential for survival analysis. Although current approaches attempt to model these interactions via co-attention between histology and genomic data, they focus on only dense local similarity across modalities, which fails to capture global consistency between potential structures, i.e. TME-related interactions of histology and co-expression of genomic data. To address these challenges, we propose a Multimodal Optimal Transport-based Co-Attention Transformer framework with global structure consistency, in which optimal transport (OT) is applied to match patches of a WSI and genes embeddings for selecting informative patches to represent the gigapixel WSI. More importantly, OT-based co-attention provides a global awareness to effectively capture structural interactions within TME for survival prediction. To overcome high computational complexity of OT, we propose a robust and efficient implementation over micro-batch of WSI patches by approximating the original OT with unbalanced mini-batch OT. Extensive experiments show the superiority of our method on five benchmark datasets compared to the state-of-the-art methods. The code is released.

  • 2 authors
·
Jun 14, 2023

Forecasting Clinical Risk from Textual Time Series: Structuring Narratives for Temporal AI in Healthcare

Clinical case reports encode temporal patient trajectories that are often underexploited by traditional machine learning methods relying on structured data. In this work, we introduce the forecasting problem from textual time series, where timestamped clinical findings -- extracted via an LLM-assisted annotation pipeline -- serve as the primary input for prediction. We systematically evaluate a diverse suite of models, including fine-tuned decoder-based large language models and encoder-based transformers, on tasks of event occurrence prediction, temporal ordering, and survival analysis. Our experiments reveal that encoder-based models consistently achieve higher F1 scores and superior temporal concordance for short- and long-horizon event forecasting, while fine-tuned masking approaches enhance ranking performance. In contrast, instruction-tuned decoder models demonstrate a relative advantage in survival analysis, especially in early prognosis settings. Our sensitivity analyses further demonstrate the importance of time ordering, which requires clinical time series construction, as compared to text ordering, the format of the text inputs that LLMs are classically trained on. This highlights the additional benefit that can be ascertained from time-ordered corpora, with implications for temporal tasks in the era of widespread LLM use.

When, Why and How Much? Adaptive Learning Rate Scheduling by Refinement

Learning rate schedules used in practice bear little resemblance to those recommended by theory. We close much of this theory/practice gap, and as a consequence are able to derive new problem-adaptive learning rate schedules. Our key technical contribution is a refined analysis of learning rate schedules for a wide class of optimization algorithms (including SGD). In contrast to most prior works that study the convergence of the average iterate, we study the last iterate, which is what most people use in practice. When considering only worst-case analysis, our theory predicts that the best choice is the linear decay schedule: a popular choice in practice that sets the stepsize proportionally to 1 - t/T, where t is the current iteration and T is the total number of steps. To go beyond this worst-case analysis, we use the observed gradient norms to derive schedules refined for any particular task. These refined schedules exhibit learning rate warm-up and rapid learning rate annealing near the end of training. Ours is the first systematic approach to automatically yield both of these properties. We perform the most comprehensive evaluation of learning rate schedules to date, evaluating across 10 diverse deep learning problems, a series of LLMs, and a suite of logistic regression problems. We validate that overall, the linear-decay schedule matches or outperforms all commonly used default schedules including cosine annealing, and that our schedule refinement method gives further improvements.

  • 4 authors
·
Oct 11, 2023

RULSurv: A probabilistic survival-based method for early censoring-aware prediction of remaining useful life in ball bearings

Predicting the remaining useful life (RUL) of ball bearings is an active area of research, where novel machine learning techniques are continuously being applied to predict degradation trends and anticipate failures before they occur. However, few studies have explicitly addressed the challenge of handling censored data, where information about a specific event (\eg mechanical failure) is incomplete or only partially observed. To address this issue, we introduce a novel and flexible method for early fault detection using Kullback-Leibler (KL) divergence and RUL estimation using survival analysis that naturally supports censored data. We demonstrate our approach in the XJTU-SY dataset using a 5-fold cross-validation strategy across three different operating conditions. When predicting the time to failure for bearings under the highest load (C1, 12.0 kN and 2100 RPM) with 25% random censoring, our approach achieves a mean absolute error (MAE) of 14.7 minutes (95% CI = 13.6-15.8) using a linear CoxPH model, and an MAE of 12.6 minutes (95% CI = 11.8-13.4) using a nonlinear Random Survival Forests model, compared to an MAE of 18.5 minutes (95% CI = 17.4-19.6) using a linear LASSO model that does not support censoring. Moreover, our approach achieves a mean cumulative relative accuracy (CRA) of 0.7586 over 5 bearings under the highest load, which improves over several state-of-the-art baselines. Our work highlights the importance of considering censored data as part of the model design when building predictive models for early fault detection and RUL estimation.

  • 5 authors
·
May 2, 2024

Model-free Approach to Evaluate a Censored Intermediate Outcome as a Surrogate for Overall Survival

Clinical trials or studies oftentimes require long-term and/or costly follow-up of participants to evaluate a novel treatment/drug/vaccine. There has been increasing interest in the past few decades in using short-term surrogate outcomes as a replacement of the primary outcome i.e., in using the surrogate outcome, which can potentially be observed sooner, to make inference about the treatment effect on the long-term primary outcome. Very few of the available statistical methods to evaluate a surrogate are applicable to settings where both the surrogate and the primary outcome are time-to-event outcomes subject to censoring. Methods that can handle this setting tend to require parametric assumptions or be limited to assessing only the restricted mean survival time. In this paper, we propose a non-parametric approach to evaluate a censored surrogate outcome, such as time to progression, when the primary outcome is also a censored time-to-event outcome, such as time to death, and the treatment effect of interest is the difference in overall survival. Specifically, we define the proportion of the treatment effect on the primary outcome that is explained (PTE) by the censored surrogate outcome in this context, and estimate this proportion by defining and deriving an optimal transformation of the surrogate information. Our approach provides the added advantage of relaxed assumptions to guarantee that the true PTE is within (0,1), along with being model-free. Finite sample performance of our estimators are illustrated via extensive simulation studies and a real data application examining progression-free survival as a surrogate for overall survival for patients with metastatic colorectal cancer.

  • 4 authors
·
Dec 18, 2024

The Impact of Medication Non-adherence on Adverse Outcomes: Evidence from Schizophrenia Patients via Survival Analysis

This study quantifies the association between non-adherence to antipsychotic medications and adverse outcomes in individuals with schizophrenia. We frame the problem using survival analysis, focusing on the time to the earliest of several adverse events (early death, involuntary hospitalization, jail booking). We extend standard causal inference methods (T-learner, S-learner, nearest neighbor matching) to utilize various survival models to estimate individual and average treatment effects, where treatment corresponds to medication non-adherence. Analyses are repeated using different amounts of longitudinal information (3, 6, 9, and 12 months). Using data from Allegheny County in western Pennsylvania, we find strong evidence that non-adherence advances adverse outcomes by approximately 1 to 4 months. Ablation studies confirm that county-provided risk scores adjust for key confounders, as their removal amplifies the estimated effects. Subgroup analyses by medication formulation (injectable vs. oral) and medication type consistently show that non-adherence is associated with earlier adverse events. These findings highlight the clinical importance of adherence in delaying psychiatric crises and show that integrating survival analysis with causal inference tools can yield policy-relevant insights. We caution that although we apply causal inference, we only make associative claims and discuss assumptions needed for causal interpretation.

SurvBench: A Standardised Preprocessing Pipeline for Multi-Modal Electronic Health Record Survival Analysis

Deep-learning survival models for electronic health record (EHR) data are hard to compare across papers because the upstream preprocessing step, which includes cohort definition, time discretisation, missingness handling, and censoring rules, is typically undocumented and inconsistent. A reported difference in concordance between two mortality models can therefore reflect any of these choices rather than a modelling contribution. We present SurvBench, an open-source preprocessing pipeline that converts raw PhysioNet exports into model-ready tensors for survival analysis. SurvBench covers four critical-care databases (MIMIC-IV, eICU, MC-MED, HiRID) and four input modalities: time-series vitals and laboratory values, static demographics, International Classification of Diseases (ICD) codes, and radiology report embeddings. Every preprocessing decision is controlled through YAML configuration. Imputation, scaling, and feature filtering are fit on the training fold only. Missingness is recorded as a binary mask alongside each feature tensor. The pipeline handles single-risk endpoints (in-hospital and in-ICU mortality) and competing-risks endpoints (a three-way emergency-department admission pathway, with home discharge treated as administrative censoring). We also provide support for harmonised cross-dataset external validation between eICU and MIMIC-IV. SurvBench is publicly available at https://github.com/munibmesinovic/SurvBench, providing a robust platform that future deep-learning EHR survival work, especially nascent multi-modal approaches, can be measured against under matched preprocessing.

  • 2 authors
·
May 11

A Differentially Private Kaplan-Meier Estimator for Privacy-Preserving Survival Analysis

This paper presents a differentially private approach to Kaplan-Meier estimation that achieves accurate survival probability estimates while safeguarding individual privacy. The Kaplan-Meier estimator is widely used in survival analysis to estimate survival functions over time, yet applying it to sensitive datasets, such as clinical records, risks revealing private information. To address this, we introduce a novel algorithm that applies time-indexed Laplace noise, dynamic clipping, and smoothing to produce a privacy-preserving survival curve while maintaining the cumulative structure of the Kaplan-Meier estimator. By scaling noise over time, the algorithm accounts for decreasing sensitivity as fewer individuals remain at risk, while dynamic clipping and smoothing prevent extreme values and reduce fluctuations, preserving the natural shape of the survival curve. Our results, evaluated on the NCCTG lung cancer dataset, show that the proposed method effectively lowers root mean squared error (RMSE) and enhances accuracy across privacy budgets (epsilon). At epsilon = 10, the algorithm achieves an RMSE as low as 0.04, closely approximating non-private estimates. Additionally, membership inference attacks reveal that higher epsilon values (e.g., epsilon geq 6) significantly reduce influential points, particularly at higher thresholds, lowering susceptibility to inference attacks. These findings confirm that our approach balances privacy and utility, advancing privacy-preserving survival analysis.

  • 3 authors
·
Dec 6, 2024

DeepSurv: Personalized Treatment Recommender System Using A Cox Proportional Hazards Deep Neural Network

Medical practitioners use survival models to explore and understand the relationships between patients' covariates (e.g. clinical and genetic features) and the effectiveness of various treatment options. Standard survival models like the linear Cox proportional hazards model require extensive feature engineering or prior medical knowledge to model treatment interaction at an individual level. While nonlinear survival methods, such as neural networks and survival forests, can inherently model these high-level interaction terms, they have yet to be shown as effective treatment recommender systems. We introduce DeepSurv, a Cox proportional hazards deep neural network and state-of-the-art survival method for modeling interactions between a patient's covariates and treatment effectiveness in order to provide personalized treatment recommendations. We perform a number of experiments training DeepSurv on simulated and real survival data. We demonstrate that DeepSurv performs as well as or better than other state-of-the-art survival models and validate that DeepSurv successfully models increasingly complex relationships between a patient's covariates and their risk of failure. We then show how DeepSurv models the relationship between a patient's features and effectiveness of different treatment options to show how DeepSurv can be used to provide individual treatment recommendations. Finally, we train DeepSurv on real clinical studies to demonstrate how it's personalized treatment recommendations would increase the survival time of a set of patients. The predictive and modeling capabilities of DeepSurv will enable medical researchers to use deep neural networks as a tool in their exploration, understanding, and prediction of the effects of a patient's characteristics on their risk of failure.

  • 6 authors
·
Aug 8, 2017

Empirical Risk Minimization under Random Censorship: Theory and Practice

We consider the classic supervised learning problem, where a continuous non-negative random label Y (i.e. a random duration) is to be predicted based upon observing a random vector X valued in R^d with dgeq 1 by means of a regression rule with minimum least square error. In various applications, ranging from industrial quality control to public health through credit risk analysis for instance, training observations can be right censored, meaning that, rather than on independent copies of (X,Y), statistical learning relies on a collection of ngeq 1 independent realizations of the triplet (X, ; min{Y,; C},; δ), where C is a nonnegative r.v. with unknown distribution, modeling censorship and δ=I{Yleq C} indicates whether the duration is right censored or not. As ignoring censorship in the risk computation may clearly lead to a severe underestimation of the target duration and jeopardize prediction, we propose to consider a plug-in estimate of the true risk based on a Kaplan-Meier estimator of the conditional survival function of the censorship C given X, referred to as Kaplan-Meier risk, in order to perform empirical risk minimization. It is established, under mild conditions, that the learning rate of minimizers of this biased/weighted empirical risk functional is of order O_{P}(log(n)/n) when ignoring model bias issues inherent to plug-in estimation, as can be attained in absence of censorship. Beyond theoretical results, numerical experiments are presented in order to illustrate the relevance of the approach developed.

  • 3 authors
·
Jun 5, 2019

Strategic Evaluation of Planning Strategies for LLM Agents in Cyber-Physical Systems

Evaluations of LLM planning agents largely ask whether a task succeeds or a declared plan is followed. In strategic cyber-physical systems, a stronger question is whether the planning architecture remains appropriate after autonomous participants respond and physics constrains the outcome. We introduce a controlled, physics-grounded benchmark built around planning-induced control trajectories: the ordered planning operations and directives through which an execution architecture acts on other agents and the physical process. It implements predefined, sequential, hierarchical, and search executors in a smart-grid demand-response system with 40 heterogeneous prosumers and an independently simulated radial feeder. The LLM is bounded to typed policy declaration and short operator messages, while schedule construction, prosumer dynamics, and power flow remain explicit code. The protocol uses paired forced-mode counterfactuals, common random response draws, and event-level deadline feasibility. Three properties follow. Architecture materially changes outcomes: forced search is the oracle in all five baseline seeds. Execution fidelity needs more than mode agreement: objective substitution holds agreement at 1.0 while increasing voltage shortfall by 2.68x. A 144-scenario, 576-episode bank has feasible oracles from three of the four architectures. A prespecified stress-held-out ridge has mean regret 90.7 (95% interval [73.8, 108.6]) and no detectable value over fixed sequential; applying known deadline feasibility before quality prediction cuts regret to 29.0 and improves over fixed sequential by 61.1. An all-feasible ablation does not beat fixed search, localising the remaining challenge to within-feasible quality selection. A five-model extension separates stress-conditioned, state-blind, and invariant declarers; latency tails show that live feasibility should be treated probabilistically.

  • 2 authors
·
Aug 3

Partially Correlated Verifier Cascades in LLM Harnesses: Concave Log-Odds, Polynomial Reliability, and Blind-Spot Ceilings

Serial verification gates are a core reliability primitive in LLM harnesses: a candidate answer is returned only if k verifier calls all accept it. Under conditionally independent gates, the recent Odds Law (arXiv:2606.15712) shows that posterior log-odds grow linearly in k, so failure decays exponentially, and states that "a tight theory of partially correlated verifier cascades remains open." This note gives a minimal such theory. Modeling the per-instance false-accept rate on the generator's own errors as a latent variable αsim G (de Finetti), the exact cascade posterior is ell_k = ell_0 - ln m_k, with m_k the k-th moment of G. Then: (i) ell_k is concave in k for every non-degenerate G -- the Odds Law is its tangent at the first gate and an upper bound; (ii) for Beta(a,b) latents, failure decays polynomially, 1-r_k asymp k^{-b}, with correlation parameter ρ_v = 1/(a+b+1); (iii) a blind-spot atom of mass 1-π at α=1 caps the evidence extractable from any number of gates at -ln(1-π) nats, so reliability saturates below 1; (iv) letting the true-accept rate also vary (βsim H) yields a trichotomy -- gates eventually always help, plateau, or actively harm -- decided by the upper-tail exponents of G and H, with closed-form crossover k^dagger. The mechanism is survivorship: errors surviving gates are the high-α ones. The theory is measurable: R repeated verdicts per instance identify the first R moments of G, so two verdicts identify ρ_v; beta-binomial likelihood and NPMLE recover the reliability curve and the ill-posed ceiling. In synthetic tests, independence-based extrapolation underestimates failure by 20x at k=5 and ~3000x at k=10; the correlated fit at R=8 tracks held-out depths. The practical lever is decorrelation -- changing model family, modality, or evidence source -- not adding gates.

  • 1 authors
·
Jul 14 2

PHMForge: Evaluating LLM Agents on Industrial Prognostics through MCP-Native, Algorithm-Grounded Tools

LLM agents are beginning to invoke industrial asset-management tools through the Model Context Protocol (MCP), yet whether they can act reliably on this substrate for safety-critical Prognostics and Health Management (PHM) is unanswered. Prior benchmarks conflate protocol fluency with reasoning, instrumentation failures with agent failures, and tool use with tool retrieval. We introduce PHMForge, an evaluation environment that closes each conflation. PHMForge ships 99 SME-authored scenarios across eight industrial asset classes spanning rotating equipment, aero-engines, and lithium-ion cells, on public datasets including NASA PCoE, served through 39 MCP-native tools wrapping published PHM algorithms (C-MAPSS, ISO~10816, Arrhenius capacity-fade models, time-series foundation models). Krippendorff's αin [0.74,,0.82] on a 30-scenario stratified rotating-equipment/aero-engine sample; the battery extension is single-rater. Across three agentic frameworks and six LLM backbones, the strongest configuration reaches 80.8\% pass@1, with the residual gap concentrated in orchestration and tool-sequencing errors. Crucially, an architectural ablation shows that replacing MCP execution with text-based Retrieval-Augmented Generation (RAG) over telemetry-equivalent evidence collapses Remaining Useful Life pass-all-3 from 100\% to 20\% (5/5 vs.\ 1/5) on the battery class, exposing the structural limits of static retrieval for prognostic computation. Trajectory decomposition shows orchestration errors dominate failures across backbones, while schema-invalid tool calls concentrate in smaller open-weight models. Frontier LLMs are stronger at calling tools than at planning when to call them. PHMForge is open-sourced with deterministic evaluators, a public leaderboard, and a datasheet.

  • 8 authors
·
May 7

OTSurv: A Novel Multiple Instance Learning Framework for Survival Prediction with Heterogeneity-aware Optimal Transport

Survival prediction using whole slide images (WSIs) can be formulated as a multiple instance learning (MIL) problem. However, existing MIL methods often fail to explicitly capture pathological heterogeneity within WSIs, both globally -- through long-tailed morphological distributions, and locally through -- tile-level prediction uncertainty. Optimal transport (OT) provides a principled way of modeling such heterogeneity by incorporating marginal distribution constraints. Building on this insight, we propose OTSurv, a novel MIL framework from an optimal transport perspective. Specifically, OTSurv formulates survival predictions as a heterogeneity-aware OT problem with two constraints: (1) global long-tail constraint that models prior morphological distributions to avert both mode collapse and excessive uniformity by regulating transport mass allocation, and (2) local uncertainty-aware constraint that prioritizes high-confidence patches while suppressing noise by progressively raising the total transport mass. We then recast the initial OT problem, augmented by these constraints, into an unbalanced OT formulation that can be solved with an efficient, hardware-friendly matrix scaling algorithm. Empirically, OTSurv sets new state-of-the-art results across six popular benchmarks, achieving an absolute 3.6% improvement in average C-index. In addition, OTSurv achieves statistical significance in log-rank tests and offers high interpretability, making it a powerful tool for survival prediction in digital pathology. Our codes are available at https://github.com/Y-Research-SBU/OTSurv.

  • 5 authors
·
Jun 25, 2025