Do "Incidental Melanomas" Exist? If so, how many are they? High Time to Decide
Bibliographic record
Abstract
Do "Clinically Insignificant, HIstological MElanoma-Like Lesions" (CIHIMELL) - to wit, merely incidental, looking-like-melanoma lesions devoid of intrinsic malignant potential - exist? The question arises from the fact that, in spite of increased diagnoses of completely excised malignant melanoma (MM) in the last two decades, mortality from advanced metastatic disease has not decreased. After a brief review of the literature, the author proposes that the existence of CIHIMELL could be affirmed through post mortem dermoscopy and histological study of any pigmented lesion, clinically or dermoscopically suspected, of several deceased patients undergoing necropsy for death causes unrelated to MM. Should the cumulative prevalence of merely histological melanomas turn out to be exceedingly high and not commensurable with the current death rates of true MM, the discrepancy would tangibly prove that indolent pigmented lesions with morphological aspect of melanoma do exist. This would clearly introduce difficulties that could satisfactorily be dealt with only through a paradigm shift in melanoma surveillance and diagnosis (which could also allow to add a piece of encouraging uncertainty to the patient-physician relationship). However, it can be expected that such an enterprise would be countered by several vested academic and commercial interests.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; both teacher heads agree on what is shown here.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".