scikit-survival-analysis

# scikit-survival -- Survival Analysis

## Overview

scikit-survival is a Python library for time-to-event analysis built on scikit-learn. It handles right-censored data (observations where the event has not yet occurred) using Cox models, ensemble methods, survival SVMs, and non-parametric estimators. All models follow the scikit-learn `fit/predict` API and integrate with Pipelines, cross-validation, and GridSearchCV.

## When to Use

- Modeling time-to-event outcomes with right-censored data (clinical trials, reliability)
- Fitting Cox proportional hazards models (standard or elastic net penalized)
- Building ensemble survival models (Random Survival Forest, Gradient Boosting)
- Training survival SVMs for margin-based learning on medium-sized datasets
- Evaluating survival predictions with censoring-aware metrics (C-index, Brier score, AUC)
- Estimating non-parametric survival curves (Kaplan-Meier, Nelson-Aalen)
- Analyzing competing risks with cumulative incidence functions
- High-dimensional survival data with automatic feature selection (CoxNet L1/L2)
- For **simpler parametric models** (Weibull, log-normal AFT) or statistical tests (log-rank), use `lifelines`
- For **deep learning survival models**, use `pycox` or `torchlife`

## Prerequisites

```bash
pip install scikit-survival scikit-learn pandas numpy matplotlib
```

**Python**: >= 3.9. **Dependencies**: scikit-learn, numpy, scipy, pandas, joblib, osqp (for some SVM solvers).

**Data format**: Survival outcomes are NumPy structured arrays with `(event, time)` fields. Events are boolean (True = event occurred, False = censored). Times are positive floats.

## Quick Start

```python
from sksurv.datasets import load_breast_cancer
from sksurv.ensemble import RandomSurvivalForest
from sksurv.metrics import concordance_index_ipcw
from sklearn.model_selection import train_test_split

X, y = load_breast_cancer()
X_train, X_test, y_train, y_test = train_test_split(X, y, test_size=0.2, random_state=42)

rsf = RandomSurvivalForest(n_estimators=100, random_state=42)
rsf.fit(X_train, y_train)

risk_scores = rsf.predict(X_test)
c_index = concordance_index_ipcw(y_train, y_test, risk_scores)[0]
print(f"C-index: {c_index:.3f}")  # e.g., 0.68

# Individual survival curves
surv_fns = rsf.predict_survival_function(X_test[:2])
for fn in surv_fns:
    print(f"5-year survival: {fn(365 * 5):.3f}")
```

## Core API

### Module 1: Data Preparation

Create structured survival arrays and preprocess features.

```python
import numpy as np
import pandas as pd
from sksurv.util import Surv
from sksurv.preprocessing import OneHotEncoder, encode_categorical
from sksurv.datasets import load_gbsg2, load_breast_cancer
from sklearn.preprocessing import StandardScaler

# Create survival outcome from arrays
event = np.array([True, False, True, True, False])
time = np.array([120.0, 365.0, 200.0, 90.0, 400.0])
y = Surv.from_arrays(event=event, time=time)
print(y.dtype)  # [('event', '?'), ('time', '<f8')]

# From DataFrame columns
# y = Surv.from_dataframe("event_col", "time_col", df)

# Load built-in datasets
# Available: load_gbsg2, load_breast_cancer, load_veterans_lung_cancer,
#            load_whas500, load_aids, load_flchain
X, y = load_gbsg2()
print(f"Shape: {X.shape}, Events: {y['event'].sum()}, "
      f"Censoring rate: {1 - y['event'].mean():.1%}")

# Encode categoricals (survival-aware one-hot)
X_encoded = encode_categorical(X)  # auto-detect and encode all categorical cols

# Standardize (critical for Cox and SVM models)
scaler = StandardScaler()
X_scaled = scaler.fit_transform(X_encoded)
```

```python
from sksurv.io import loadarff

# Load ARFF format (Weka format)
data = loadarff("survival_data.arff")
X_arff, y_arff = data[0], data[1]  # DataFrame, structured array
```

### Module 2: Cox Proportional Hazards

Semi-parametric model: h(t|x) = h_0(t) * exp(beta^T x). Interpretable coefficients as log hazard ratios.

```python
from sksurv.linear_model import CoxPHSurvivalAnalysis, CoxnetSurvivalAnalysis, IPCRidge

# Standard Cox PH model
cox = CoxPHSurvivalAnalysis(alpha=0.0, ties="breslow")
cox.fit(X_train, y_train)
print(f"Coefficients: {cox.coef_}")  # log hazard ratios
# Hazard ratio interpretation: exp(coef) = HR for 1-unit increase
risk_scores = cox.predict(X_test)  # Higher = higher risk

# Survival function for individual patients
surv_funcs = cox.predict_survival_function(X_test[:3])
for fn in surv_funcs:
    print(f"5-year survival: {fn(365 * 5):.3f}")
```

```python
# Penalized Cox (elastic net) -- for high-dimensional data (p > n)
coxnet = CoxnetSurvivalAnalysis(
    l1_ratio=0.9,           # 0=Ridge, 1=Lasso, between=Elastic Net
    alpha_min_ratio=0.01,   # smallest alpha / largest alpha ratio
    n_alphas=100,           # steps in regularization path
)
coxnet.fit(X_train, y_train)

# Feature selection: non-zero coefficients
selected = np.where(coxnet.coef_ != 0)[0]
print(f"Selected {len(selected)} / {X_train.shape[1]} features")

# IPCRidge: accelerated failure time model (predicts log survival time)
ipcridge = IPCRidge(alpha=1.0)
ipcridge.fit(X_train, y_train)
log_survival_time = ipcridge.predict(X_test)
```

### Module 3: Ensemble Methods

Non-parametric tree-based models for complex non-linear relationships.

```python
from sksurv.ensemble import (
    RandomSurvivalForest,
    GradientBoostingSurvivalAnalysis,
    ComponentwiseGradientBoostingSurvivalAnalysis,
    ExtraSurvivalTrees,
)

# Random Survival Forest -- robust, minimal tuning
rsf = RandomSurvivalForest(
    n_estimators=200, min_samples_split=10, min_samples_leaf=15,
    max_features="sqrt", random_state=42, n_jobs=-1,
)
rsf.fit(X_train, y_train)
risk = rsf.predict(X_test)

# Gradient Boosting -- best performance, needs tuning
gbs = GradientBoostingSurvivalAnalysis(
    loss="coxph",           # "coxph" or "ipcwls" (AFT)
    n_estimators=300, learning_rate=0.05, max_depth=3,
    subsample=0.8, dropout_rate=0.1, random_state=42,
)
gbs.fit(X_train, y_train)

# ComponentwiseGB --