Deep Survival Analysis in Multimodal Medical Data: A Parametric and Probabilistic Approach with Competing Risks

Accurate survival prediction is critical in oncology for prognosis and treatment planning. Traditional approaches often rely on a single data modality, limiting their ability to capture the complexity of tumor biology. To address this challenge, we introduce a multimodal deep learning framework for survival analysis capable of modeling both single and competing risks scenarios, evaluating the impact of integrating multiple medical data sources on survival predictions. We propose SAMVAE (Survival Analysis Multimodal Variational Autoencoder), a novel deep learning architecture designed for survival prediction that integrates six data modalities: clinical variables, four molecular profiles, and histopathological images. SAMVAE leverages modality specific encoders to project inputs into a shared latent space, enabling robust survival prediction while preserving modality specific information. Its parametric formulation enables the derivation of clinically meaningful statistics from the output distributions, providing patient-specific insights through interactive multimedia that contribute to more informed clinical decision-making and establish a foundation for interpretable, data-driven survival analysis in oncology. We evaluate SAMVAE on two cancer cohorts breast cancer and lower grade glioma applying tailored preprocessing, dimensionality reduction, and hyperparameter optimization. The results demonstrate the successful integration of multimodal data for both standard survival analysis and competing risks scenarios across different datasets. Our model achieves competitive performance compared to state-of-the-art multimodal survival models. Notably, this is the first parametric multimodal deep learning architecture to incorporate competing risks while modeling continuous time to a specific event, using both tabular and image data.

DeCaFlow: A Deconfounding Causal Generative Model

Causal generative models (CGMs) have recently emerged as capable approaches to simulate the causal mechanisms generating our observations, enabling causal inference. Unfortunately, existing approaches either are overly restrictive, assuming the absence of hidden confounders, or lack generality, being tailored to a particular query and graph. In this work, we introduce DeCaFlow, a CGM that accounts for hidden confounders in a single amortized training process using only observational data and the causal graph. Importantly, DeCaFlow can provably identify all causal queries with a valid adjustment set or sufficiently informative proxy variables. Remarkably, for the first time to our knowledge, we show that a confounded counterfactual query is identifiable, and thus solvable by DeCaFlow, as long as its interventional counterpart is as well. Our empirical results on diverse settings (including the Ecoli70 dataset, with 3 independent hidden confounders, tens of observed variables and hundreds of causal queries) show that DeCaFlow outperforms existing approaches, while demonstrating its out-of-the-box flexibility.