Searcharxiv⌕ Search
Home/Archive/arXiv

arXiv · 2504.05093

Flexible Estimation of the Heterogeneous Non-Parametric Component in a Relative Survival Cure Model

Fabrizio Di Mari·Roberto Rocci·Silvia Rossi·Giovanna Tagliabue·Roberta De Angelis
View original source ↗Read source document ↗Export metadata ↓

Abstract

Estimating the cure fraction in a diseased population, especially in the presence of competing mortality causes, is crucial for both patients and clinicians. It offers a valuable measure for monitoring and interpreting trends in disease outcomes. When information on the cause of death is unavailable or unreliable, the Relative Survival (RS) framework is the preferred approach for estimating Net Survival, which represents survival in a hypothetical scenario where the disease of interest is the only possible cause of death. In the context of cancer, RS often reaches a plateau, indicating that a portion of diagnosed patients is cured, as they have the same risk of dying as a comparable group of healthy individuals with similar demographic characteristics. Classical RS cure models use logistic regression to estimate the fraction of cured patients. However, this functional form is somewhat arbitrary, and misspecifying it can severely distort the resulting cure indicators. Consequently, evaluations of the efficacy of cancer treatments at the population level could be inaccurate, leading to biased decision-making regarding patient care. In this paper, we address this issue by relaxing the parametric assumption and considering flexible functions of the covariates within the framework of \textit{Generalized Models} and \textit{Neural Networks}. We design an EM algorithm for these RS cure models and conduct a simulation study to compare our proposals with the classical approach. We apply our methodology to a real-world dataset from a historical Italian cancer registry. The results demonstrate that our proposed models outperform the classical approach and provide valuable insights into the survival outcomes of Italian colon cancer patients.

Explore related subjects

stat.MEstat.AP

Keep this discovery

BibTeXRIS

Fabrizio Di Mari, Roberto Rocci, Silvia Rossi, Giovanna Tagliabue, Roberta De Angelis. 2025-04-07. Flexible Estimation of the Heterogeneous Non-Parametric Component in a Relative Survival Cure Model. https://arxiv.org/abs/2504.05093

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related papers

arXiv2026

Surprise Reduction and Nullification in Bayesian and Inverse Bayesian Inference under Ambiguous Prediction-Error Attribution

In non-stationary environments, prediction errors may signal environmental change or transient outliers, and adaptive systems must track such changes without overreacting to outliers. We distinguish surprise reduction, which updates beliefs to fit observations, from surprise nullification, which weakens constraints imposed by the predictive structure, and formalize both within Bayesian and inverse Bayesian (BIB) inference. Belief and likelihood updates are derived from variational objectives sharing a nullification strength, determined endogenously by minimizing surprise under the candidate post-update predictive distribution. In the Gaussian case, nullification expands belief and likelihood variances by a common factor relative to standard Bayesian updating, leaving the ratio unchanged. BIB thus defers attribution of the prediction error, committing to neither latent-state change nor observation-process uncertainty. The nullification strength is carried over as a candidate and is maintained or released according to the predictive surprise of the next observation. In a mean estimation task with outliers and changepoints, no scanned parameter setting of a Sage-Husa-type adaptive Kalman filter, fixed-strength BIB variant, or belief-forgetting-only variant outperforms BIB in both changepoint tracking and post-outlier stability. An oracle-informed reduced Bayesian model tracks changepoints better but is less stable after outliers. Although BIB maintains no explicit hypotheses about changepoints or outliers, it generates event-dependent dynamics. The learning rate increases after changepoints, whereas after outliers, nullification is released, and this increase is suppressed. Deferring attribution and letting subsequent observations differentiate the responses may constitute a principle of adaptive inference in non-stationary environments.

stat.ME↗
arXiv2026

Generalized Ridge Refitting for the Lasso and Prediction Improvement Bounds

We study a class of Lasso based estimators obtained by applying a quadratic correction on the Lasso equicorrelation set. The penalty matrix determines both the magnitude and geometry of the correction and contains, among other cases, the isotropic Lasso--Ridge correction, least squares refitting, Gram proportional interpolation between the Lasso and least squares, and coordinate specific penalties. We first derive a closed form representation and isolate the positive gain component of the resulting prediction improvement. We then control the remaining stochastic linear term in expectation by localizing the random signed equicorrelation model around a deterministic reference support. This yields a finite sample expectation bound that explicitly accounts for the randomness induced by Lasso model selection. The resulting decomposition provides a unified framework for understanding when Lasso based quadratic corrections can improve prediction.

stat.ME↗
arXiv2026

Discretization in covariate-adaptive randomization: gains and losses

Covariate-adaptive randomization(CAR) is widely implemented in clinical trials to balance prognostic covariates across treatment arms. Continuous covariates are often discretized into strata in practice, yet their consequences are not clearly understood. This paper provides a comprehensive study of the impact of discretization on both the CAR design process and the inferential results thereafter. We establish the asymptotic properties of both imbalance measures and treatment effect estimators under discretized and non-discretized settings. Practical recommendations are given on when and how discretization should be employed. We show that discretization in design is generally recommended, as it enhances robustness against model misspecification. However, if the true model is known, the most efficient strategy is to balance covariates according to that model in the design. The theoretical results are corroborated by extensive simulation studies and an empirical application to a diabetes trial dataset. Together, the results clarify the gains and losses of discretization in CAR and pave the way for learning impact of discretization to other designs and beyond.

stat.ME↗