Dynamic Prediction using Time-Dependent Cox Survival Neural Network

The target of dynamic prediction is to provide individualized risk predictions over time which can be updated as new data become available. Motivated by establishing a dynamic prediction model for the progressive eye disease, age-related macular degeneration (AMD), we proposed a time-dependent Cox model-based survival neural network (tdCoxSNN) to predict its progression on a continuous time scale using longitudinal fundus images. tdCoxSNN extends the time-dependent Cox model by utilizing a neural network to model the non-linear effect of the time-dependent covariates on the survival outcome. Additionally, by incorporating the convolutional neural network (CNN), tdCoxSNN can take the longitudinal raw images as input. We evaluate and compare our proposed method with joint modeling and landmarking approaches through comprehensive simulations using two time-dependent accuracy metrics, the Brier Score and dynamic AUC. We applied the proposed approach to two real datasets. One is a large AMD study, the Age-Related Eye Disease Study (AREDS), in which more than 50,000 fundus images were captured over a period of 12 years for more than 4,000 participants. Another is a public dataset of the primary biliary cirrhosis (PBC) disease, in which multiple lab tests were longitudinally collected to predict the time-to-liver transplant. Our approach achieves satisfactory prediction performance in both simulation studies and the two real data analyses. tdCoxSNN was implemented in PyTorch, Tensorflow, and R-Tensorflow.