Chapman 1

Mackenzie Chapman
ENG 106-R48-44889
Brittany Biesiada
October 23, 2014
Melanoma
Nikolic, J, Loncar-Turukalo, T, Sladojevic, S, Marinkovic, M, and Janjic, Z. Melanoma risk
prediction models. Vojnosanitetski Pregled. 71.8 (2014): 756-766. Medline. Web. 6
October 2014.
a.

This article is a case study on risk prediction models for the fastest growing
cancer, melanoma. It shows that people with a certain hair color, eye color, etc.
have a higher probability of getting melanoma. I am interested in this article
because it shows the problem with a growing cancer, melanoma, and how it can
be targeted during early stages.

2. The CARS model is a common way to analyze an introduction of a scientific article.

There are three moves in the CARS model, Move 1 2 &3. Each move also has different
steps. Move 1: Step 1 is claiming centrality. In this article, the author claims centrality
when he says, Considering the continuous trend of increasing incidence of melanoma in
the last 50 years, with the fastest growing incidence of all malignant diseases in the
United States, melanoma is becoming one of the most urgent problems of medicine
today (Nikolic, et.al 758). Move 1: Step 2 is making topic generalizations. The author
generalizes the topic when he says, Epidemiological data indicate a constant increase in
the melanoma incidence, ranging from 4% to 6% per year (758). The final step of move
one is reviewing previous items of research. The author reports, Most epidemiological
studies highlight the following as key factors for the development of melanoma:
intermittent UV exposure, sunbeds, blistering sun burns in childhood, fair skin phototype

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(Fizpatrick I and II), a great number of common naevi, the presence of atypical naevi,
blond hair, blue eyes, freckles, melanoma in family (758).
The next move is when the author establishes a niche. In move two, the author
counter claims, indicates a gap, and raises a question. He counter claims his topic by
saying, Usually they summarize results of different meta-analysis or multicentric studies
that involve great number of participants from different regions in order to overcome bias
of some specific environmental characteristic (758). Then he indicates a gap, saying,
However, the significance and relevance of some constitution risk factors largely depend
on geographic region, different latitudes and different races (758). The author of this
particular article does not raise a question in his introduction.
The last move involves the author outlining his/her purpose, announcing present
research, announcing principal findings, and indicating structure of the research. The
author outlines his purpose when he states, The aim of this study was to identify risk
factors in our population, to measure their respective importance and determine the most
significant risk factors for melanoma prediction (758). Then, he announces his present
research, saying, Based on the selection of the most important risk factors, we created
two prognostic models based on logistic regression (LR) and alternating decision trees
(ADT) and assessed their usefulness for identification of patients at risk to develop
melanoma (758). In this article about melanoma, the author does not announce his
principal findings. Instead, he placed all of his findings under the result section (759).
The author also does not indicate the structure of the research article, but, his article
follows a typical format of a scientific article, giving an introduction, methods, results,
discussion, and conclusion.

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3. The author of this article retrieves his research from credible researchers such as KK
Reddy, Kubica AW, and Rigel DS that have discussed this topic of melanoma through
scientific articles, research studies, and educated conversations. He lists all of his
references on the final page of his article. For example, one researcher, Reddy, did
research on Vitamin D level and basal cell carcinoma, squamous cell circulation, and
melanoma risk (765). The article Reddy wrote was published in 2013. The author of this
article references forty-six different scientists throughout this article and formally cites
them at the end. He gives their name, what article they wrote, the editor, the publishing
date, volume, and page numbers (765) The scientists he cites researched a variety of
topics from trends of cutaneous melanoma in The Netherlands: increasing incidence
rates among all Breslow thickness categories and rising mortality rates since 1989 to
Data mining model using simple and readily available factors could identify patients at
high risk for hepatocellular carcinoma in chronic hepatitis (766).
The author also cites the information that each researcher published specifically
within the article. He puts an endnote on the information used from their article. For
example, corresponding to the example above. Reddy, KK.s, information, listed as
number fourteen on the reference list, was cited as These days there are also
contradictory data bout the association between melanoma and obesity, Parkinsons
disease, vitamin D14, immunosuppressive therapy... (758). As seen in this example, the
author does not formally cite the researchers information. Instead, he puts an endnote to
the number the researcher is listed on the reference page.
4. The author of this article uses a specific tone: both informative and scientific. The author
informs the reader on different aspects of the topic of melanoma. He tells the reader how

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it is one of the fastest growing cancers in the world today (758). He also explains how
harmful the cancer can be and how it affects the body. However, his main argument
within the paper is showing people how to identify risk factors of this deadly cancer
(758). He also is very scientific in his research method and data used for the study. In the
method portion of the article, he lists in-depth procedures of his case study (759). He also
gets information from physicians, scientists, etc.
The author uses a formal writing style throughout the article. As he addresses
main points about melanoma and risk prediction models, he shows detailed information
about the topic. He formally states his methods and statistical analysis through showing
different scientific models like SPSS for Windows (759). Then, he discusses his results
in-depth, giving one paragraph to describe a specific risk factor of melanoma (762).
Lastly, he discusses his findings by showing logistic regression on the selected factors
(764).
The author discusses his ideas as a traditional scientific article analysis, using
descriptions, graphs, and tables. The author has a traditional format and design of the
article: starting with an introduction, listing methods, discussing results, having a
discussion, and then forming a conclusion. Within the results section of the article, he has
one graph and two tables that add to the credibility of his article. The first table shows the
distribution of risk factors in the patients and controls and statistical significance
analysis (760). The author uses this table to show the different risk factors they test to
form the risk prediction model (760). The next graph shows the logistic regression
model of risk factors for melanoma prediction, which lays out the main factors of
melanoma and how they affect patients (761). The last table is the distribution of

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probabilities in controls, which shows how probable it is for a patient to get melanoma
when they are affected by a certain risk factor (761). He uses these different tables and
graphs to give a visual aid to his writing, showing how the different factors correlate with
others.
5. The thesis of the paper is:
In order to avoid relying on an expert knowledge, experience and ability to
estimate impact of all environmental and constitutive factors in a patient the
proposed predictive models would standardize screening process and focus the
surveillance programs to those who would benefit most. Both models are intuitive
and computationally efficient offering transparent and understandable decisionmaking. Model dissemination and its simple usage could lead to recognition and
prevention of undesirable behavioral habits and consecutively the reduction in the
incidence and mortality from melanoma (759).
The author supports his thesis by using specific evidence of the specific risk
factors of melanoma. He formulates a study, using 697 participants: 341 patients and 356
controls (759). The risk factors that are most prevalent in melanoma based on his
previous test were, level of education, intermittent UV exposure, use of sunbeds, HCT,
level of solar damage, hair color, eye color, and the number of constant naevi (761). The
logistic regression (LR) analysis shows how these factors listed above are associated with
melanoma (761).
The author then discusses how his results prove his thesis. Most people think that
bad sunburns and the lack of sunscreen are root causes to melanoma (763). But the tests
performed in this article show that melanoma comes from other factors. First, he shows

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how the use of sunbeds causes melanoma, saying if exposure to sunbeds is before 35
years, the patient would have a 75% higher chance of getting melanoma (764). Second,
people with red, blonde/light brown hair, and people with blue/green eyes have a higher
probability of getting melanoma (764). Lastly, the article shows how the number of
common naevi and dysplastic naevi (DN) in our data coincide with results of other
studies confirming that the higher number of nave, the higher risk of melanoma (764).
The authors results coincided with other researchers saying, DN and more than 50
common naevi increase risk for melanoma (764).
I think the author is succeeds his purpose of informing people about the risk
factors that coincide with melanoma. He gives specific details throughout the paper,
showing how the logistic regression analysis proves that melanoma has different risk
factors involving hair color, eye color, etc. He discusses common thoughts about
melanoma and how they are wrong, and he also shows the truth about this deadly cancer.