Questions From Users of the Manual

Q: I am putting together an annotated bibliography for a manuscript. What is the correct order recommended by the AMA Manual of Style for citing multiple articles by the same author? Is it by date of publication or article title?

A: The JAMA Network journals do not use a name-date style of reference citation. Instead they use a superscript reference citation system. If you look in the 10th edition of the Manual of Style, section 3.6 (Citation), you will see further information on this. So, it matters not the date of publication or the article title. What is key is the order in which the reference is cited in the paper, eg, the first reference to be cited would be reference 1, the second would be reference 2. (And if reference 1 is cited again later in the paper, it would still remain reference 1.)

Q: What do you tell authors who object to the house style your publications follow by saying that “Everybody does X [rather than what you recommend].”?

A: When people respond like this, I find that it’s helpful to look at what a few key style manuals or journals in the field (based on their Instructions for Authors) do in areas in which people have complaints or concerns. If you can put together a little chart (nothing fancy) showing that indeed maybe it is not EVERYBODY who does X, real data can sometimes calm the fevered brow. And sometimes you may find that indeed most others do have a different policy than what your house style recommends. Then it may be time to reconsider your policy. Sometimes this is how style policies change, and that can be a good thing. We learn from our authors just as we hope they learn from us.—Cheryl Iverson, MA

Questions From Users of the Manual

Q: I am writing on behalf of my editorial department. We are all very curious to know when we should follow the style outlined in 3.13.2, which calls for headline caps and italics for the publication’s title vs the style outlined in 3.15. 5, which in most cases calls for the title to be set in roman and title case. Why, in example 6 in 3.15.5, is the title set like those for 3.13.2? Is there a distinction between bulletins and reports?

A: Perhaps the line here is fine.  In 3.13.2, the examples are all bulletins. These are more like books, hence the cap and italic style you asked about. In 3.15.5, the examples are all reports. These might be booklike but they often are more like journal articles. The advice right before the examples is to use journal style for articles and book style for monographs. Reference 6, which you ask about, seems more booklike as it has a volume number. Sometimes it is really difficult to know what something is. If it is available online, you might look at it and be more easily able to determine what sort of “beast” it is.

Q: To adhere to the guidelines in the AMA Manual of Style must an author document all sources with footnotes in the text in chronological order? It’s my understanding that doing so serves, in essence, as a form of fact checking. Does your manual offer any other other guidance on fact checking?

A: Yes, we recommend that all sources cited in a manuscript be included in the reference list for the manuscript (with a few exceptions, which we recommend citing parenthetically in the text). These are not, however, cited chronologically (if by that you mean from the earliest published to the most recently published) but rather in order of citation in the manuscript (ie, the first reference cited would be reference 1, that cited second would be reference 2, etc; and if a reference is cited several times, it would each time retain its original reference number, so that if reference 2 is not only cited second but also appears later in the manuscript, it would still remain reference 2).

Whether this citation of references constitutes “fact checking” is a bit trickier to be sure of. As our manual states in the chapter on references, “References serve 3 primary purposes—documentation, acknowledgment, and directing or linking the reader to additional resources.” Citing a reference, and thereby crediting another source for the material cited, and also linking the reader to additional resources, is related to fact checking in that a reader could follow that link (ie, go to the reference cited) and make sure that it has been cited accurately. Whether that constitutes fact checking, though, is unclear. It does ensure that the original source has been cited/quoted correctly. But it doesn’t tell a reader if in fact that source is correct.—Cheryl Iverson, MA

Questions From Users of the Manual

Q: We are having a discussion about –ic and –ical. Dictionaries often use both. Where does the AMA Manual stand on this?

A: Please refer to the Correct and Preferred Usage chapter in the manual. You’ll see an entry on this very subject. In addition, there are entries on some of the pairs of words where the meaning of the –ic version is different from that of the –ical version (eg, classic/classical, historic/historical).

Q: Does AMA style advise against using a period after the abbreviation Inc?

A: Yes, we advise against using a period after the abbreviation Inc. This is addressed in section 14.7.

Q: In the course of developing a manuscript, an author has retired. Should we delete her affiliation? Or perhaps indicate something about her retirement in parentheses?

A: I would list the author’s affiliation, assuming she was affiliated with this institution while working on the paper. Then, follow the guidance about Author’s Affiliation (section 2.3.3) if a person has moved. This would mean adding an indication that Dr X is now retired. The style used for this notation will depend on the design of the journal involved. —Cheryl Iverson, MA

Questions From Users of the Manual

Q: I am used to writing “compared with” when discussing results/measurements. Can you please comment on whether this is correct?

A: This is addressed in the glossary in chapter 11. See “compare to, compare with.” You’ll see there that “compare with” is usually used when the aim is to examine similarities or differences in detail.

Q: I was trained in other settings to ignore having to write out the state on first mention if the city is well known, especially if the readership is primarily American. For example, Chicago, Los Angeles, and San Francisco would not require adding the state name on first mention. Something like Spring Green would. What would AMA style require?

A: Please see section 14.5, where this is addressed in detail. The key sentence is this:  “At first mention, the name of a state, territory, possession, province, or country should be spelled out when it follows the name of a city.” In earlier editions, we used to follow a policy something like what you describe but changed that as it was a matter of opinion what was “well known” and what was not.  Also, with the international readership of so many publications, this becomes a trickier question.—Cheryl Iverson, MA

Questions From Users of the Manual

Q: I note in the manual that you do not require the use of the registered trademark symbol with brand names, as long as an initial capital letter is used (see 5.6.16, Use of Trademark Names in Publication).  Does this guideline apply to copy in medical books as well as medical journals?

A:  You are right that our manual does not encourage the use of the little “R” in a circle or the superscript TM to denote trademarks but rather relies on the initial cap to signify a trademark. As to what style would apply to books (medical or other), it really all comes down to what style the book publisher uses. The Chicago Manual of Style (section 8.152) states: “Although the symbols [cap R in a circle and superscript TM] for registered and unregistered trademarks, respectively) often accompany trademark names on product packaging and in promotional material, there is no legal requirement to use these symbols, and they should be omitted wherever possible.”

I think you would be fairly safe in zapping the symbol and just using the initial cap, unless the style guide you are following in editing a book dictates otherwise.

Q: What do you recommend re capitalization for something like the word “test” or “examination” or “questionnaire” in names of specific tests, examinations, or questionnaires?

A: Our style manual (section 10.3.8) advises the following regarding capping the “t” on “test” when it follows the name of a specific test. I would extrapolate from this to cover similar questions.

Tests.  The exact and complete titles of tests and subscales of tests should be capitalized.  The word test is not usually capitalized except when it is part of the official name of the test.  Always verify exact names of any tests with the author or with reference sources.

Examples where a cap would be correct include the Mini-Mental State Examination and the Minnesota Multiphasic Personality Inventory.—Cheryl Iverson, MA

Questions From Users of the Manual

Q: My colleagues and I are debating the correctness of the following sentence:  If any of the side effects gets serious, contact the study doctor.

A: If you remove the words “of the” from your sentence, you will find the answer(s) readily apparent. If there is one side effect, you’d use the singular:  “If any side effect becomes serious….”  If there is more than one side effect, you’d use the plural:  If any side effects become serious….”

Q: Should “week” or “weeks” be used in the following sentences?

 The changes in serum creatinine remained stable from week/weeks 48 to 96.

Nausea typically develops between the fourth and sixth week/weeks of pregnancy.

A: We would suggest using “weeks” in both examples. It would, of course, not be incorrect to repeat “week,” eg, “…at week 48 and week 96,” but for efficiency you could use “…at weeks 48 and 96.”—Cheryl Iverson, MA

Questions From Users of the Manual

Q: I cannot find anything in the AMA Manual of Style about how to cite an article in a magazine. Please help.

A: You are correct that we do not address citations to magazines, primarily because the material we focus on is more scholarly. However, you could extrapolate from the information on how to cite a journal article (see section 3.11). Here is an example of citation of a magazine article:

Angell R. This old man: life in the nineties. New Yorker. February 17&24, 2014:60-65.

You’ll notice that although we prefer giving the year;volume number(issue number):inclusive pages in our citations to journal articles, some magazines do not use volume and issue numbers but instead rely on the issue date. This seems to be true of the New Yorker, and this article was in a double issue, so you’ll see that I have suggested using issue date:inclusive page numbers.

Q: What is the best way to send a question to you regarding the content of the style manual?

A: You may write to the style manual at

Q: For package insert references, many times the manufacturer and marketing company are the same. However, if they are not, which company should be listed in the reference citation?

A: It might be helpful in the case of a manufacturer and a marketer to list both. In this case, you could separate them by a semicolon:

Onglyza [package insert]. Princeton, NJ: Bristol-Myers Squibb Co; Wilmington, DE: AstraZeneca Pharmaceuticals LP; July 2009.—Cheryl Iverson, MA

Questions From Users of the Manual

Q: Do superscript reference numbers go before or after colons? What about periods and commas?

A: Superscript reference numbers go before colons and semicolons and after commas and periods. See section 3.6.

Q: When will the next edition of the AMA Manual of Style be published?

A: We have begun work on the next (11th) edition but do not yet have a projected publication date. I think 2016 is realistic. In the meantime, I hope you avail yourself of the online updates, which provide policy changes, etc. Those are free, if you do not have an online subscription. The monthly quizzes (which are free to subscribers) are also a good way (between editions) to see more examples.

Q: On PowerPoint slides, how do you recommend citing reference sources: on each slide that is not the presenter’s own, or at the end of the presentation?

A: At present, our style manual does not address style questions related to PowerPoint presentations; however, we are considering adding a few guidelines on this in the next edition. For now, I would suggest adding the reference sources on each slide, as a footer. Because the slides are likely to be pulled apart from the entire presentation and used by others, having the source with the content seems advisable.—Cheryl Iverson, MA