Summary

Risk prediction is a type of supervised learning where the goal is to predict the probability that a person will experience an event within a specific amount of time. This kind of prediction may be useful in clinical settings, where identifying patients who are at high risk for experiencing an adverse health outcome can help guide strategies for prevention and treatment. The oblique random survival forest (RSF) is a supervised learning technique that has obtained high prediction accuracy in general benchmarks for risk prediction [@jaeger2019oblique]. However, computational overhead and a lack of tools for interpretation make it difficult to use the oblique RSF in applied settings.

aorsf is an R package with fast algorithms to fit and interpret oblique RSFs, allowing users to obtain an accurate risk prediction model without losing efficiency or interpretability. aorsf supports exploration and customization of oblique RSFs, allowing users to select the fitting procedure for an oblique RSF or supply their own procedure (see examples provided in documentation for orsf_control_custom()). Whereas existing software for oblique RSFs does not support estimation of variable importance (VI), aorsf provides multiple techniques to estimate VI with the added flexibilty of allowing users to supply their own functions where applicable (see documentation for orsf_vi()).

Statement of need

The purpose of aorsf is to allow oblique RSFs to be fit and interpreted efficiently. The target audience includes both analysts aiming to develop an accurate risk prediction model (e.g., see @segar2021development) and researchers who want to conduct experiments comparing different techniques for fitting oblique RSFs (e.g., see @katuwal2020heterogeneous).

Related software

The obliqueRF and RLT R packages support oblique random forests (RFs) for classification and regression, but not survival. The ranger, randomForestSRC, and party packages support axis-based RSFs (see Background section) but not oblique RSFs. The obliqueRSF R package fits oblique RSFs, but has high computational overhead, provides a limited set of tools to interpret oblique RSFs, and does not enable customization of routines used to fit oblique RSFs.

Background

Random forests (RFs) are large sets of de-correlated decision trees [@breiman2001random]. Trees in the RF may be axis-based or oblique. Axis-based trees split data using a single predictor, creating decision boundaries that are perpendicular or parallel to the axes of the predictor space. Oblique trees split data using a linear combination of predictors, creating decision boundaries that are neither parallel nor perpendicular to the axes of their contributing predictors. The increased flexibility of their decision boundaries allows oblique trees to produce more controlled partitions of a predictor space compared to their axis-based counterparts (Figure 1). However, the added flexibility has a computational cost, as the number of potential oblique decision boundaries to search through may be much larger than the number of axis-based boundaries.

knitr::include_graphics("tree_axis_v_oblique.png")

Censoring

A common challenge in risk prediction is censoring. The term 'censor' indicates partial observation of something. Censoring occurs often in medical studies that track the elapsed time from a baseline visit to the occurrence of an event. For example, censoring can occur if study coordinators lose contact with a participant or the study concludes before the participant experiences the event.

Decision trees can engage with censored outcomes by recursively partitioning data using standard descriptive tests (e.g., the log-rank test) and applying estimation techniques for censored outcomes to generate predicted values in leaf nodes, such as the survival curve or the cumulative hazard function [@ishwaran2008random].

Newton Raphson scoring

The efficiency of aorsf is primarily attributed to its use of Newton Raphson scoring to identify linear combinations of predictor variables. aorsf uses the same approach as the survival package to complete this estimation procedure efficiently. Full details on the steps involved have been made available by @therneau_survival_2022. Briefly, a vector of estimated regression coefficients, $\hat{\beta}$, is updated in each step of the procedure based on its first derivative, $U(\hat{\beta})$, and second derivative, $H(\hat{\beta})$:

$$ \hat{\beta}^{k+1} = \hat{\beta}^{k} + U(\hat{\beta} = \hat{\beta}^{k})\, H^{-1}(\hat{\beta} = \hat{\beta}^{k})$$ While it is standard practice in statistical modeling to iteratively update $\hat{\beta}$ until a convergence threshold is met, the default approach in aorsf only completes one iteration (see orsf_control_fast()). The rationale for this approach is based on two points. First, while completing more iterations reduces bias in the regression coefficients, general benchmarking experiments have found it does not improve the discrimination or Brier score of the oblique RSF [@aorsf_arxiv]. Second, computing $U$ and $H$ requires computation and exponentiation of the vector $X\hat{\beta}$, where $X$ is the matrix of predictor values, but these steps can be skipped on the first iteration if an initial value of $\hat{\beta} = 0$ is chosen, allowing for a reduction in required computation.

Variable importance

Estimation of VI is a common technique used for interpretation of RFs. Permutation, a standard approach to estimate VI, measures how much a RF's prediction accuracy decreases after randomly permuting values of a given variable. If the variable is important, de-stabilizing decisions based on the variable should reduce the RF's prediction accuracy.

aorsf includes multiple functions to estimate VI, including permutation VI and a faster approach to estimate VI using analysis of variance [@menze2011oblique]. In addition, aorsf includes a novel technique for VI that is designed for compatibility with oblique decision trees: 'negation importance.' Similar to permutation, negation VI measures the reduction in an oblique RFs prediction accuracy after de-stabilizing decisions based on a variable. However, instead of permuting values of a variable, negation VI flips the sign of all coefficients linked to a variable (i.e., it negates them). As the magnitude of a coefficient increases, so does the probability that negating it will change the oblique RF's predictions.

Benchmarking

General benchmarks of prediction accuracy, computational efficiency, and estimation of VI using aorsf and several other software packages are available [@aorsf_arxiv]. In these benchmarks, aorsf has matched or exceeded the prediction accuracy of obliqueRSF while running hundreds of times faster. Additionally, simulation studies have found that negation VI improves the oblique RSF's ability to discriminate between signal and noise predictors compared to existing VI techniques.

Acknowledgements

The development of this software was supported by the Center for Biomedical Informatics at Wake Forest University School of Medicine and the National Center for Advancing Translational Sciences (NCATS), National Institutes of Health (NIH), through Grant Award Number UL1TR001420. Dr. Pajewski was additionally supported by grant award P30 AG021332 from the NIH. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

References



bcjaeger/aorsf documentation built on April 3, 2025, 4:16 p.m.