Discrete-time Competing-Risks Regression with or without Penalization

Many studies employ the analysis of time-to-event data that incorporates competing risks and right censoring. Most methods and software packages are geared towards analyzing data that comes from a continuous failure time distribution. However, failure-time data may sometimes be discrete either because time is inherently discrete or due to imprecise measurement. This paper introduces a novel estimation procedure for discrete-time survival analysis with competing events. The proposed approach offers two key advantages over existing procedures: first, it accelerates the estimation process; second, it allows for straightforward integration and application of widely used regularized regression and screening methods. We illustrate the benefits of our proposed approach by conducting a comprehensive simulation study. Additionally, we showcase the utility of our procedure by estimating a survival model for the length of stay of patients hospitalized in the intensive care unit, considering three competing events: discharge to home, transfer to another medical facility, and in-hospital death.

PyDTS: A Python Package for Discrete Time Survival Analysis with Competing Risks

Time-to-event analysis (survival analysis) is used when the outcome or the response of interest is the time until a pre-specified event occurs. Time-to-event data are sometimes discrete either because time itself is discrete or due to grouping of failure times into intervals or rounding off measurements. In addition, the failure of an individual could be one of several distinct failure types; known as competing risks (events) data. This work focuses on discrete-time regression with competing events. We emphasize the main difference between the continuous and discrete settings with competing events, develop a new estimation procedure, and present PyDTS, an open source Python package which implements our estimation procedure and other tools for discrete-time-survival analysis with competing risks.

3D Convolutional Sequence to Sequence Model for Vertebral Compression Fractures Identification in CT

An osteoporosis-related fracture occurs every three seconds worldwide, affecting one in three women and one in five men aged over 50. The early detection of at-risk patients facilitates effective and well-evidenced preventative interventions, reducing the incidence of major osteoporotic fractures. In this study, we present an automatic system for identification of vertebral compression fractures on Computed Tomography images, which are often an undiagnosed precursor to major osteoporosis-related fractures. The system integrates a compact 3D representation of the spine, utilizing a Convolutional Neural Network (CNN) for spinal cord detection and a novel end-to-end sequence to sequence 3D architecture. We evaluate several model variants that exploit different representation and classification approaches and present a framework combining an ensemble of models that achieves state of the art results, validated on a large data set, with a patient-level fracture identification of 0.955 Area Under the Curve (AUC). The system proposed has the potential to support osteoporosis clinical management, improve treatment pathways, and to change the course of one of the most burdensome diseases of our generation.