A Hierarchical Bayesian Model for Personalized Survival Predictions

Abstract

We study the problem of personalizing survival estimates of patients in heterogeneous populations for clinical decision support. The desiderata are to improve predictions by making them personalized to the patient-at-hand, to better understand diseases and their risk factors, and to provide interpretable model outputs to clinicians. To enable accurate survival prognosis in heterogeneous populations we propose a novel probabilistic survival model which flexibly captures individual traits through a hierarchical latent variable formulation. Survival paths are estimated by jointly sampling the location and shape of the individual survival distribution resulting in patient-specific curves with quantifiable uncertainty estimates. An understanding of model predictions is paramount in medical practice where decisions have major social consequences. We develop a personalized interpreter that can be used to test the effect of covariates on each individual patient, in contrast to traditional methods that focus on population average effects. We extensively validated the proposed approach in various clinical settings, with a special focus on cardiovascular disease.