BiologybioRxiv

Ranked by formulaVerdict: Notable

Discovering Prognostic Risk Strata and Heterogeneous Progression Routes from Cross-Sectional Survival Data

Inferring how individual patients progress towards higher disease risk typically requires longitudinal observations, which are often unavailable.

By Alzaid, Wright, Minhas

Score█████░░░░░4.6

Caveats

  • Not randomized: its findings are associations.
  • Preprint; not yet peer reviewed.

VerdictWorth a reader's time today.

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Abstract

Inferring how individual patients progress towards higher disease risk typically requires longitudinal observations, which are often unavailable. Population-level analyses of cross-sectional data can identify differences between risk groups but may obscure heterogeneous progression patterns across individual patients. In this work, we introduce GOTSurv, a framework for patient-specific progression modelling. Using cross-sectional survival data, it first learns to rank patients by survival risk and automatically stratify them into prognostic risk groups without requiring predefined risk cut-offs. It then uses unbalanced optimal transport to infer patient-specific changes in the magnitude and direction of features associated with transitions towards higher-risk strata. We evaluated GOTSurv across ten TCGA cancer cohorts using two modalities: gene expression (n=4,767) and whole-slide image representations (n=4,655), with external validation in two independent cohorts. Compared with established survival models, GOTSurv generally achieved stronger prognostic stratification without requiring predefined risk cut-offs, while retaining competitive survival-ranking accuracy. More importantly, GOTSurv enabled the discovery of individualised progression trajectories associated with increasing risk, revealing distinct progression patterns even among patients within the same risk stratum. Overall, GOTSurv provides a novel framework for inferring heterogeneous, patient-specific progression patterns from cross-sectional survival data, enabling the identification of distinct pathways associated with increasing disease risk and informing the development of personalised therapeutic strategies. The code for GOTSurv is available at https://github.com/EtharZaid/GOTSurv/.

E. Alzaid, G. Wright, F. Minhas

The editor's rubric

Heuristic review

Leverage4 / 5
A general-purpose tool used across several fields (Adam, ResNet, LoRA, next-generation sequencing).
24% of this desk’s rubric
Magnitude2 / 5
Solid incremental gain on a meaningful problem.
16% of this desk’s rubric
Evidence3 / 5
Solid: multiple benchmarks or cohorts, ablations, fair baselines, released code or data.
20% of this desk’s rubric
Novelty3 / 5
A genuinely new approach to an open problem.
20% of this desk’s rubric
Trajectory2 / 5
Some room to improve with obvious engineering.
10% of this desk’s rubric
Stakes3 / 5
Meaningful benefit to many people within a few years.
10% of this desk’s rubric

Editor’s rationale

Heuristic triage from title and abstract text only, not a reading of the paper. Cues found: method (we propose, new method); breadth (many tasks); novelty (alternative to status quo, discovery); verification (multiple benchmarks, independent replication, code released); stakes (mortality, major disease, prevention or cure). Red flags: not randomized.

How the score was computed

rank-2026-10-18

Score█████░░░░░4.6

Score = 10 × (75% × adjusted merit / 10 + 15% × attention + 10% × freshness)

Desks place stronger verdicts first, then use this score to order work within the same verdict.

Merit
6.0 / 10
Weighted rubric, evidence-gated.
Adjusted merit
5.0 / 10
Shrunk toward the desk prior by editor confidence (50%).
Attention
0%
Citations, upvotes, points, mentions.
Freshness
88%
Half-life decay since publication.

No attention signals recorded yet.

The record

  • Reviewed by heuristic-v10 on Nov 5, 2026, 05:48 UTC. Paper type: clinical.
  • Categories: bioinformatics
  • TOP, No.5 in the Front page edition of November 5, 2026.
  • TOP, No.2 in the Biology edition of November 5, 2026.