Follow Instructions!

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It was my first day of high school, and the bell had just rung announcing first period. There I sat in Mrs Ruth’s earth science class at a desk on the opposite side of the room from the blackboard, but not so far away, I hoped, that it was obvious I was trying to make myself invisible among the other wide-eyed freshmen. The desks were arranged in clumps, and as Mrs Ruth introduced herself, she stopped at each one, licking her thumb and counting out worksheets.

“Read the instructions,” Mrs Ruth said, “and then complete the worksheet. It shouldn’t take you more than 2 minutes.”

Two minutes?! I thought. A list of bullet points ran the length of the page. I looked to see if anyone else was feeling similarly overwhelmed, but my new classmates were already scribbling away as fast as they could, so I followed their lead. Per Mrs Ruth’s directions, I read the instructions—“Write your name neatly in the top right-hand corner, and read every question before answering any.”—and moved on to the first bullet point.

  • How many sides does a triangle have?

Three, duh. I scrawled the answer. The second bullet point told me to, from memory, list as many dinosaurs as I could. The class was quiet except for pencils dutifully scratching answers. These questions were a breeze. Maybe this worksheet would only take 2 minutes after all.

  • What is the capital of Ohio?

Columbus!

  • What is Will Smith’s character’s name on The Fresh Prince of Bel-Air?

Will Smith—he plays himself!

And before I knew it, I reached the last bullet point, which, surprisingly, wasn’t a question at all.

  • Do not answer any of the previous questions. Make sure your name is written neatly, and hand in a blank worksheet.

Groans rippled across the room as other students arrived at the last bullet point. When all our pencils were down and our cheeks were red with embarrassment, Mrs Ruth asked who’d read the instructions. Of course, we all raised our hands. But Mrs Ruth corrected us: no, we hadn’t. Reading the instructions meant more than glancing the words. It meant understanding and acting on them; if we’d written anything on the page other than our names, we’d already failed our first high school assignment.

The AMA Manual of Style is, at its core, a gigantic set of instructions, and on top of the style guide, the websites for JAMA and the journals comprising the JAMA Network each contain links to lengthy Instructions for Authors that explain everything from how manuscripts should be formatted to the number of tables, figures, references, words, etc, individual article types allow. A large part of the job of a manuscript editor is to make sure articles follow the instructions they’re supposed to in preparation for publication, and on a surprising number of occasions, I’ve worked with authors who have argued or rejected fundamental style points or have ignored instructions on the website specific to the journal that’s publishing their research. The instructions aren’t arbitrary, and the AMA Manual of Style exists to help ensure the reporting of research and data is rigorous, lucid, and consistent.

I think back to Mrs Ruth and my first day of high school often: if you don’t read, understand, and follow the instructions, you’ve failed before you’ve even begun.—Suzanne Walker

Unconfusing “The Confusables”

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I was recently gifted a copy of Dreyer’s English: An Utterly Correct Guide to Clarity and Style, a book by Random House Copy Chief Benjamin Dreyer. It is one of the latest in a line of modern guides on editing and writing that shed the stuffiness usually associated with language and instead take on the subject with wit and humor.

Amid references to pop culture and classic literature, tips on spelling and punctuation, and even a relatable confession that the rules of grammar aren’t always  interesting (sorry, linguistics enthusiasts), there is a chapter called “The Confusables.” Confusables are homonyms, synonyms, similarly spelled words, words with comparable meaning — a word you thought you meant but did not. As Dreyer puts it, “Spellcheck is a marvelous invention, but it can’t stop you from using the wrong word when the wrong word you’ve used is a word (but the wrong word).”

He’s right. Spellcheck and software like Grammarly are useful, but they don’t perform the same function as an editor. This can feel hard to explain to businesses looking for a way to cut costs. Copy editors are increasingly difficult to find in newsrooms, advertising agencies, and other companies that decide to leave writers to edit their own copy. But, like with many of the finer points of editing, confusables are hard to detect, and a keen, well-trained eye is needed to spot them. (Not to mention it feels pretty darn satisfying to catch one.)

Dreyer includes a list of common confusables in his book. Here are a few I have seen recently:

Affect/effect

This is one of the more common pairs of confusables. There are some subtler differences between the 2 words, but most of the time the RAVEN rule (Remember, Affect is a Verb, and Effect is a Noun) will get you by.

Casual/causal

In medical and scientific editing, we frequently discuss the use of causal language in studies (ie, the inference that there is a relationship between variables).  Casual language might be used to describe a relationship with friends. A misuse of either of these words might be easy to read over because they are very close in spelling, but they are very different in meaning.

Discreet/discrete

To be discreet means to be prudent, while discrete means separate or distinct. I used to have a hard time differentiating these 2 words until a fellow editor shared her mnemonic device that the t between the e’s of discrete keeps them separate from each other.

Intermediate/intermittent

These confusables, though different in definition, have some crossover in usage. Intermediate means in the middle, while intermittent means in intervals. So, sure, a solution could be mixed using either intermediate or intermittent shaking. But how does one quantify an intermediate shake? It’s likely intermittent is meant in this situation, but if something isn’t completely clear, it’s always best to ask the author to clarify.

Peak/peek

This pair is tricky because writers might think of the oft-combined “sneak peek” and want to use the ea spelling for both. However, peak refers to a high point, such as the peak concentration of a drug, and peek means to look. The way I keep these straight is associating the ee of peek with the ee of peer or the 2 e’s in eye.

Rational/rationale

These 2 words have similar spelling and meaning, with only one letter setting them apart. However, rational means to be reasonable while rationale is the reason behind said reasonableness.—Jamie Scott

Talk to Me

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Imagine this scenario: it’s 4:30 pm on a Friday, you’ve been stalking your Outlook account for 7 straight hours, your deadline is coming up fast, and STILL the corresponding author of the article you’ve been working on for the whole week hasn’t gotten in touch via email or phone or passenger pigeon to answer your one SIMPLE QUERY that you probably already know the answer to but for the sake of best practices have to receive from them.

So with the prospect of being late for a much-needed end-of-the-week happy hour hanging over you, you consider your options. Do you ring for reinforcements? Do you call in the cavalry?

Sound familiar?

Communicating with authors is one of the most important and challenging parts of being a manuscript editor. There might be an impulse to jump to stereotypes about physicians when speculating why an author isn’t getting back to you (eg, Mr/Ms Ivory Tower can’t stoop to take time from being important and well-known to speak to Plebeian You) but the truth is that there are myriad reasons why authors can fall behind on their communication. While nobody wants to be the jerk who is insensitive to a busy schedule with patients, family emergencies, or a vigilant spam folder, you also have a job to do. If your work performance is at least partially based on meeting deadlines, you may want to consider one or a few of the following strategies to encourage a response.

1. Round up the gang. If a corresponding author isn’t responding to you in a timely way, you may want to reach out to some of the article’s other authors to enlist their help. You could do this in a simple, relatively nonconfrontational way by copying them on correspondence you share with the corresponding author, or you can give them a quick call. This may give you an uncomfortable feeling that you are tattling on the author (I’m not sure what the editorial version of “snitches get stitches” is–maybe “nerds get words”?), but remember that they also have a professional obligation to you. By reaching out you may be giving them an opportunity to re-delegate responsibilities in light of things going on behind the scenes.

2. Phone a friend. Manuscript editors are often only dealing with articles after they’ve been accepted, but it is likely that the authors have talked to multiple people affiliated with the journal along the article’s journey toward publication. If your journal has an editorial office that has shared correspondence with the author or somebody who worked with them during the peer review process, reaching out to them to ask if they can contact the author might yield a result. Some people are more comfortable communicating with people they’ve already dealt with, and a roundabout way of getting the information you need is a better alternative than radio silence.

3. Appeal to a higher power. In a perfect world titles wouldn’t matter, but let’s be real: they do. If the lack of author communication has gotten to the level where it is seriously gumming up the works, and if you can assess that it’s worthy of your supervisor’s time, escalating the situation upward might be your best option. It is truly astonishing how the words “Executive” and “Senior” can expedite a response!

4. Deploy the Shame Lady from Game of Thrones.

(Just kidding.)

So the next time you find yourself with a failure to communicate, don’t despair and whimper “Why won’t you talk to me?” to the computer screen—consider using one of these strategies to get the conversation rolling, the deadline met, and yourself to happy hour.—Amanda Ehrhardt

Race and Ethnicity

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One of my favorite chapters in the AMA Manual of Style is about inclusive language, particularly the section about race/ethnicity (11.10.2). Race/ethnicity is a complicated topic because these categories have cultural and biological implications. In scientific research, it is important to specify race/ethnicity of study participants to understand the generalizability of the results. AMA Style instructs authors to indicate who classified the race/ethnicity of study participants (ie, the investigator or the participant).

Recently, I edited a research article with a table of participant characteristics that listed race/ethnicity as white, black/African American, Asian, and other. AMA Style notes that Asian and Asian American are not equivalent or interchangeable and that authors can be queried to clarify. All participants in this study were from the United States, so I asked the author about using Asian American instead of Asian. The author declined the edit, so Asian it stayed.

The editor in me shrugged it off. Editing is meant to serve authors and their research, and unless something is inaccurate, I have no problem reverting to the author’s original wording. After all, even the CDC website uses Asian and Asian American interchangeably.

The noneditor side of me, though—the child of immigrants who grew up in the United States and spent childhood summers in Hong Kong and Taiwan—was frustrated. I have been told I’m either not Asian enough or not American enough, and I try to explain that I’m both. I’m Asian American.

(As a sidebar, I also want to point out that black/African American presents its own problems. Many researchers do include non-Hispanic black, but where does that leave Afro-Latinx? This could be a whole other blog post.)

Of course, I understand that it may be exhausting to list out all the racial/ethnic groups in a table, especially considering page limits. I do appreciate when authors list more specific racial/ethnic groups, even if for many of them, n = 0. Any type of representation is a big step. However, I’ve also seen manuscripts in which the only race designations are white and nonwhite. The AMA Manual of Style notes that we should avoid using “non-” (eg, white and nonwhite participants) because it is a nonspecific “convenience” grouping. Instead, editors can query the author about using a specific race/ethnicity or using multiracial or people of color to address the heterogeneous ethnic background of many people. As an editor, a human, or even a potential study participant, I would self-report my race/ethnicity as Asian American or a person of color but never as nonwhite.—Iris Y. Lo

Questions From Users of the Manual

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The following are questions from you, faithful AMA Manual of Style users, seeking clarification of AMA style guidelines or guidance on topics not covered in the current edition.

Q: I think I know the answer to this but want to be sure. Do you italicize “ad libitum” in “Animals were provided ad libitum access to standard chow”?

A: The manual (22.5.4: Specific Uses of Fonts, Typography) says this about italics:

[Use italics] for some non-English words and phrases that are not shown among English terms in the current edition of Merriam-Webster’s Collegiate Dictionary or in accepted medical dictionaries. Italics are not used if words or phrases are considered to have become part of the English language, eg, café au lait, in vivo, in vitro, en bloc.

Merriam-Webster’s online dictionary lists “ad libitum,” so there is no need to italicize it. Interestingly, the example is “rats fed ad libitum.”

Q:  I am wondering: How does one cite a clinical trial as a reference? Do we treat them like a PI, or like a website? Do we include the identifier?

A: It would look most like a website and yes, inclusion of the identifier is recommended:

1. Evaluation of phage therapy for the treatment of Escherichia coli and Pseudomonas aeruginosa wound infections in burned patients (PHAGOBURN). ClinicalTrials.gov identifier: NCT02116010. https://www.clinicaltrials.gov/ct2/show/NCT02116010. Updated July 23, 2015. Accessed October 13, 2018.

Q:  Hi, Should there be a comma between a last name and “Jr” in a byline? 

For example:  Krzysztof Goniewicz, PhD; Frederick M. Burkle, Jr, PhD

A: No, AMA style does not include a comma before Jr or Sr, or before III, IV, etc.

See the policy and examples in chapter 8.2.1, Punctuation, Comma.

Q:  Does the manual have any position on whether “24/7” or “24-7” are acceptable in formal prose, with the meaning “at all times”? Thanks!

A:  As far as formatting, it’s not in the current AMA manual, but the Chicago Manual of Style and AP stylebook both use “24/7.”

Merriam-Webster’s dictionary lists “24-7” as the primary entry, with “24/7” as a variant.

The JAMA Network journals have generally preferred “24/7” considering that the slash serves to indicate “per” (24 hours per 7 days). Numbers joined with a hyphen (24-7) could be confused for a range or expression of variability, although the context of the passage should alleviate that.

As to “24/7” being acceptable in formal prose, it’s clearer to say “all the time”  or something less jargony:

            The hospital has stroke expertise available 24/7.

            Rewrite: The hospital has stroke expertise always available.

            Rewrite: The hospital has stroke expertise available around-the-clock.

Q: I know you aren’t supposed to refer to patients by their diseases, eg, “asthmatics.” How does that apply to the following sentence:

 Of the 196 patients, 20.4% (40) were made comfort-focused care, and 79.6% (156) remained full codes. 

What is the alternative for “full code”? 

A: Stylebook committee member Phil Fontanarosa, MD, MBA, replied:

With advance directives, patients can choose to have any or none of these procedures and also can opt for “comfort care,” which usually involves pain control, perhaps some sedation, and other comfort measures.

For the sentence, you could revise as something like the following: “Of the 196 patients, 20.4% (40) decided to have comfort-focused care, and 79.6% (156) opted to receive full resuscitation efforts.” 

Q: Hi, I have 2 questions about authors’ initials:

1.  If the journal typically uses periods after middle initials in the byline and the author has 2 middle initials, should there be a space between them?

2. If the journal uses first and last author initials in the Disclosures section, should there be periods and spaces between them?

A: The answer to both questions is yes.  Here’s an example from the 11th edition (forthcoming later this year) re the second question:

Author Affiliations:  Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong (S. K. W. Chan, S. W. Y. Chan, Hui, Chang, Chen); The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong (S. W. K. Chan, Chang, Chen); School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong (Pang, Yan).

Have a question? Send it in to stylemanual@jamanetwork.org or tweet to @AMAManual.—Stacy L. Christiansen, MA

Dictionaries: An Editor’s Best Friend

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Part of the fun of editing medical content is learning all about the newest treatments and scientific advances, but as someone without a science background, I find myself looking for resources that can help me understand some of the more technical terminology.

You may ask, “What about Google?” Google offers the collective knowledge of the Internet right at our fingertips, right? Well, sort of. Sometimes I don’t have the time to sort through all of the results. I want the correct answer now! Subject-specific medical dictionaries are just the thing when I’m in a hurry (which is almost always because DEADLINES).Two resources that I use are A Manual of Orthopaedic Terminology (print) and the National Cancer Institute (NCI) dictionaries (web).

In the days when I edited orthopaedic surgery manuscripts, A Manual of Orthopaedic Terminology (Nelson FR, Blauvelt CT. A Manual of Orthopaedic Terminology. 8th ed. Philadelphia, PA: Elsevier Saunders, 2015) was my go-to resource for terminology related to musculoskeletal disease, brief descriptions of imaging techniques, and common orthopaedic abbreviations. The section on fracture classifications saved me from sifting through a ton of search engine results. Don’t even get me started on the eponymous procedures and approaches! As much as I love this resource, it’s not comprehensive. My heart sank when I used this book to look up surgical approaches for hand surgery and saw “Surgical approaches are too numerous and complicated to describe here. Refer to Canale ST, Beaty J, 2013.”Um, okay.

I found the web-based NCI dictionaries one day when I was working on an oncology manuscript and found myself turning to Google for the 10th time in 2 hours (I love you, Google, but this is ridiculous!). Enter the NCI Dictionary of Cancer Terms and the NCI Drug Dictionary to save the day. Of the 2 dictionaries, I use the Dictionary of Cancer Terms the most. The definitions aren’t too technical, and new terms and definitions are added monthly. Right now, 8386 terms are included. The search interface is easy to use, and allows you to search for partial terms.

As you might expect, the definitions and descriptions in the NCI Drug Dictionary are more technical than those in the Dictionary of Cancer Terms. In addition to definitions, the Drug Dictionary entries include alternate drug names and hyperlinks to more information on each drug (such as active clinical trials using the drug). The NCI Drug Dictionary was useful when I recently came across a table with an alphabet soup of chemotherapy regimens. What exactly is the FOLFIRI regimen?

Let’s use the NCI Drug Dictionary to break this down. A search of FOLFIRI returns 4 results (click for larger):

Those definitions seem pretty straightforward. They even include the trade names for some of the regimens (FOLFIRI-Avastin). The NCI Drug Dictionary seems like a good place to begin a search, but it may be a good idea to cross-check some of the drug names using the USAN Council website; “5-fluorouracil” may not be the preferred name. Clicking on the link for the regimen will redirect you to a page that lists the full definition and another link to the NCI Thesaurus. In this case, the full definitions are short and are right here in the search results—no need to click on another link!

Subject-specific dictionaries can be a reliable alternative to wading through thousands of Google results. What about you? Do you use any subject-specific resources? Tell us in the comments.—Juliet Orellana

Advice After Mischief Is Like Medicine After Death

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When acquaintances learn that I am an editor, a common response is “I better watch what I say around you.” I would like everyone to watch what they say around me at all times, but for reasons having nothing to do with my career.

Still, that response is often followed by curiosity and questions. Giving advice is one of life’s simple pleasures. Giving advice is even better when someone actually asks for it. Is any writing more concentrated than an advice column? It’s the written equivalent of a shot of absinthe but better for you. My advice hero is Carolyn Hax, and I have also enjoyed Emily Yoffe and Miss Manners. I won’t claim to belong in their illustrious company but I do have the AMA Manual of Style. I don’t think they do.  

I’ve selected questions from the last year whose answers can get you leafing through the manual. As you read these and have questions in turn of your own, remember that, unlike me, the AMA Manual of Style is always there for you.

Dear AMA Style Manual Guru,

I am indexing binomial organism names and have come up with a shortcut that separates the genus from species when the genus is otherwise repeated. Can you help me justify this decision?

Rogue Editor

Dear Rogue Editor,

We are all learners here and I object to the hierarchy implied when you refer to me as a guru. In the interest of collaboration, please call me Sir.

AMA Style Manual Guru

Dear Sir,

I am indexing binomial organism names and have come up with a shortcut that separates the genus from species when the genus is otherwise repeated. Can you help me justify this decision?

Rogue Editor

Dear RE,

No. See 13.1.1, Alphabetization and Sorting.

Dear Sir,

I’m using an acronym that relies on irregular capitalization when spelled out. I am worried that readers will feel misled or as if the acronym is too forced. How can I handle this discrepancy?  Asking for a friend.

Dear Nameless,

You worry too much. Readers will not question the acronym if they follow 10.6, Acronyms and Initialisms. You should too. Or your friend should. Look, you both should. An irregular use of capitalization will be harder for readers to follow than standard capitalization. By the way this column has a word count, so let’s dispense with salutations and sign offs and stick with Q and A.

Q: If you have a hyphenated compound in a page heading, do you capitalize the second half of the word: First-Line Therapy? or First-line Therapy?

A: Because “first-line” appears in Webster’s as a specific term, the AMA Manual of Style indicates that the “l” would be lowercase. See 10.2.2, Hyphenated Compounds. When each part of a hyphenated term carries equal weight, capitalize the initial letter of both words. I always enjoy capitalization questions. Keep them coming.

Q: Even though you prefer capitalization questions, I have a question about pluralization. In a world in which most signage offends grammarian sensibilities (Free Kitten’s to a Good Home), an editor (not unlike you) noted that my paper used “too many and’s.” How should I respond to this editor?

A: See if you can use serial commas instead of successive and’s and look up 9.6, Plurals of Symbols, Letters, Numbers, and Years. Then thank your editor for helping your article attain clarity for readers. You’re welcome.

Q: Why can’t I use the numerical expression of ordinal numbers? They keep getting edited out and I think they are clear and that the visual effect communicates more quickly than spelled ordinals.

A: This is the third (not 3rd) time you’ve asked. I know it sounds harsh but it’s for your own good and someday you’ll thank me. You just can’t. Now stop asking. Numeric expressions of ordinals may be jarring and interrupt the flow of text (see 19.2.5, Ordinals).

Q: I often see the pronoun “one” presented as the number. What’s this whole world coming to?

A: True, the pronoun should be spelled out (19.2.3, One Used as a Pronoun). You may see someone interpret a pronoun as the countable “1,” and it may get into print even when the pronoun precedes a prepositional phrase (“1 of us” for “one of us”). The only assurance I can offer is that no one was harmed in the publication of that phrase and the sun still rises and sets each day.

Q: “Two weeks of symptoms is expected” or “Two weeks of symptoms are expected”?

A: Smart money is on the first choice. A unit of measure uses a singular verb. See 9.2, Collective Nouns. Noun phrases is are funny that way. Your ears may have to adjust to this new knowledge.

Q: I have a father in law problem. He constantly undermines me. My wife is his only daughter, and when I am at the grill (my specialty!), he maneuvers into my area so he can flip the burgers himself. Then he claims that I don’t know how to grill. How can I get him to stop?

A: You have a father-in-law problem. See Hyphen, 8.3.1. —Timothy Gray

Patient Privacy

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Sometimes before I go to bed, I like to check in on one of my favorite YouTubers, Dr Pimple Popper (the nom de internet of dermatologist Sandra Lee), who posts videos of dermatologic procedures and skin care treatments. I particularly enjoy watching videos of dilated pore extractions, and I don’t mind watching lipoma extractions either (although I do sometimes fast-forward through the excisions). I know these types of videos can get viewers’ stomachs churning a bit, but I think it’s no worse than various photographs in medical journals I have worked at over the years. And because of my occupation, I do wonder about patient privacy and anonymity.

Patients featured on this YouTube channel may have a cyst near their eye or ask for blackheads to be removed from their cheek, and their faces are clearly visible. In many videos, Dr Lee chats with her patients, and although she sometimes edits out personal details, some of it stays. Dr Lee says that patients do sign consent forms before videos are published.

Similarly, when manuscript editors of medical journals encounter photographs of patients, we must review whether the photograph might intrude on patient privacy. Authors must obtain written permission from patients (or their legally authorized representatives) for any descriptions, photographs, or videos of patients or identifiable body parts and indicate that such consent was obtained in the Methods or Acknowledgment section. When I started in this field as an editorial assistant, I processed a manuscript that described a skin lesion on a patient’s back. In an accompanying photograph, the patient’s distinctive tattoo was visible, and I needed to ask the author to either obtain patient consent or have the photograph cropped because the patient (as well as anyone who knew he had that tattoo) would be able to identify himself. Results of imaging studies and photos of laboratory slides may also have identifying information that should be removed.

Protecting patient privacy also extends to what is in the text of an article. When editing case descriptions, case reports, and personal essays, nonessential identifying data (eg, sex, specific ages, race/ethnicity, occupation) should generally be removed unless the author has permission or the information is clinically or scientifically relevant and important. Authors and editors should not falsify or fictionalize details; doing so may introduce false or inaccurate data.

Read more about patient’s rights to privacy and anonymity in section 5.8.2 of the AMA Manual of Style.—Iris Y. Lo

Offensive Words and Apologetic Quotation Marks: Sorry Not Sorry

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News organizations everywhere had an important editorial decision to make in early January 2018 when President Trump categorized certain countries in a defamatory manner during a closed-door discussion about immigration in the Oval Office with Senators Dick Durbin and Lindsay Graham, among others.

  • “Trump decries immigrants from ‘shithole countries’ coming to US” (CNN headline)
  • “Trump derides protections for immigrants from ‘shithole’ countries” (Washington Post headline)
  • “‘Fox & Friends’ host called for Trump to clarify ‘s—hole’ comment shortly before denial” (The Hill headline)

In scientific reporting, as in politics and life, things sometimes get ugly, and when they do, we turn to apologetic quotation marks. In the examples above, the term shithole is a part of the story; without using the offensive term, the story’s meaning is lost. It’s interesting that these 3 examples apply the apologetic quotation marks in 3 different ways. The first example includes “countries” within the quotation marks, which is not necessary. The Washington Post example gets it right. And the example from The Hill is not fooling anyone. If you’re going to include it, include it. Crossing out a few letters in the offensive term is the literary equivalent to putting black bars over a patient’s eyes to make the patient “unidentifiable.” (←ironic use of apologetic quotation marks.) 

This is not a picture of my cat:

This is not an offensive word:

S—HOLE

You get the point.

The revised edition of the AMA Manual of Style will provide expanded guidance in the “Apologetic Quotation Marks” section of the Punctuation chapter, which currently only states that apologetic quotation marks are “sometimes used around words for special effect or to indicate irony.” Additional guidance will note that in some instances, the use of a potentially offensive term might be unavoidable if it is a direct quotation that is important to an article (eg, in a news story). In such cases, the offensive term may be published within quotation marks. The New York Times occasionally opens up its policy on including offensive terms in print. Ultimately, whether or not to include offensive language in an article is an editorial decision that comes down to how the term relates to the meaning of a story.—Lauren Fischer

   



Looking Forward to the 11th Edition

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At the most recent annual conference of the American Medical Writers Association, we received a sneak peek at some of the changes to come with the AMA Manual of Style 11th edition. AMA Manual of Style Committee Members Cheryl Iverson, Stacy Christiansen, and Annette Flanagin gave an overview of some highlights, including changes to the way references are styled, updates taking into account the growing presence of social media, and changes to nomenclature. Other topics included updates to corrections processes, clarification of authorship guidelines, and data sharing rules.

In this post, I thought I’d share some of the changes that I’m most excited about as an editor, many of which promise to make the editing process easier and more intuitive. Several new guidelines for styling references caught my attention. For example, electronic references in the current edition mirror traditional references with the addition of a URL in the middle of the reference and a date accessed at the end. The new edition will put URLs at the end of a reference, similar to how DOIs currently appear. Another welcome change is the omission of publisher locations from references to books and reports, which seems sensible given the multinational nature of publishing and the increasing move toward digital formats.

An update to the style of tables and figures was also covered in the presentation. Starting with the 11th edition, column heads in tables and axis labels in graphs will appear in sentence case capitalization rather than title case. Table and figure headings and labels in scientific publishing often contain a great deal of text, making it all the more important to display that text in a way that’s as easy as possible for readers to parse. In addition to saving space, the use of sentence case capitalization throughout figures and tables will make these elements appear more standardized and easier to read.

The new edition also makes some helpful distinctions between AMA style preference and alternatives considered acceptable. For example, it is now acceptable to use of “they” as a singular pronoun. In addition to circumstances in which “they” is a person’s preferred pronoun, this construction can also be helpful in preserving patient confidentiality (eg, avoiding the disclosure of patients’ sex in a small sample size to preserve anonymity).

Many other exciting changes are anticipated with the upcoming 11th edition. Stay tuned for more!—Heather Green