A Large-Scale Neutral Comparison Study of Survival Models on Low-Dimensional Data

This work presents the first large-scale neutral benchmark experiment focused on single-event, right-censored, low-dimensional survival data. Benchmark experiments are essential in methodological research to scientifically compare new and existing model classes through proper empirical evaluation. Existing benchmarks in the survival literature are often narrow in scope, focusing, for example, on high-dimensional data. Additionally, they may lack appropriate tuning or evaluation procedures, or are qualitative reviews, rather than quantitative comparisons. This comprehensive study aims to fill the gap by neutrally evaluating a broad range of methods and providing generalizable conclusions. We benchmark 18 models, ranging from classical statistical approaches to many common machine learning methods, on 32 publicly available datasets. The benchmark tunes for both a discrimination measure and a proper scoring rule to assess performance in different settings. Evaluating on 8 survival metrics, we assess discrimination, calibration, and overall predictive performance of the tested models. Using discrimination measures, we find that no method significantly outperforms the Cox model. However, (tuned) Accelerated Failure Time models were able to achieve significantly better results with respect to overall predictive performance as measured by the right-censored log-likelihood. Machine learning methods that performed comparably well include Oblique Random Survival Forests under discrimination, and Cox-based likelihood-boosting under overall predictive performance. We conclude that for predictive purposes in the standard survival analysis setting of low-dimensional, right-censored data, the Cox Proportional Hazards model remains a simple and robust method, sufficient for practitioners.