Discrete Survival Knowledge Distillation for Competing Risks Analysis

Accurate prediction in survival analysis with competing risks is challenged by rare event rates and limited effective sample sizes. Knowledge distillation offers a promising way to transfer information from an external teacher to improve a local student, but existing methods are overwhelmingly developed for uncensored outcomes and do not directly extend to survival analysis, where censored observations provide only partial information. Moreover, prior work often assumes that teacher and student share identical outcome definitions, whereas in competing risks settings, they may differ in outcome granularity and event definitions, further complicating knowledge transfer. To address these gaps, we propose DiSKD (Discrete Survival Knowledge Distillation), a deep learning framework for discrete-time competing risks that integrates teacher predictions via a cause-specific, time-dependent Kullback-Leibler divergence. DiSKD enables flexible and privacy-conscious transfer without requiring raw data sharing, remains robust to model misspecification or outcome-definition heterogeneity, and adaptively weights teacher guidance by emphasizing compatible teachers while down-weighting less relevant ones. Simulation studies and real-world applications demonstrate improved discrimination and calibration.