27 January 2026, 14.15 Stockholm
Predictive performance at different time horizons in the presence of competing risks: machine learning versus statistical time-to-event models
Speaker: Josline Adhiambo Otieno, Department of Statistics, Umeå University
Abstract: Few studies have evaluated competing risk models at multiple time points despite the cumulative incidence of the outcome of interest changing throughout the observation time. This study focused on evaluating the performance of traditional statistical models (the cause specific Cox and Fine-Gray (FG) models), a tree-based model (random survival forest (RSF) for competing risks), a deep-learning-based model (DeepHit) and pseudo-observation-based models (linear regression and random forest (RF) models) for competing risk prediction across multiple evaluation time points. Three evaluation measures are reported. The analyses were based on two datasets of different sizes, the Primary Biliary Cirrhosis dataset, for benchmarking, and a large dataset from the Swedish stroke register (Riksstroke). All models demonstrated a similar trend in performance across horizons in both datasets. Model discrimination improved from short term to midterm followed by a decline, while calibration and overall prediction accuracy consistently worsened. The RSF model achieved better overall performance for short-term prediction in a smaller dataset with a high proportion of outcome of interest, while the RF-pseudo-based model performed well in short-term prediction on a large dataset with rare events. On the other hand, the FG model showed better predictive performance for long-term prediction in both samples. The study concluded that model performance of competing risk models vary substantially across evaluation time points and datasets, highlighting the need for horizon-specific evaluation to guide model selection.
Venue: SAM.A.233