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

When Worlds Collide

Hooray for grammar! AMA Style Insider was pleased and surprised to find our humble blog linked from the website of Midwestern singer-songwriter Sufjan Stevens. Subjects, objects, Miley Cyrus, and AMA style—it’s all coming together.—Brenda Gregoline, ELS

Quiz Bowl: Sentence Structure

One of the challenges for medical editors is to synthesize a great deal of information into clear, readable prose. To accomplish this task, we often have to wade through a murky bog of confusing comparisons, run-on sentences, or large amounts of data. We must tread lightly so as not to distort the meaning of the text or the accuracy of the data, but tread we must.

This month’s style quiz gives users the opportunity to practice their editing skills in a more substantive manner. The quiz provides 6 examples of convoluted text that require a fine editorial hand. The following is one example from the quiz:

Adolescent participants (aged 13-17 years) were recruited from 9 pediatric and family medicine clinics located in 3 urban areas in Washington State in the Group Health system from April 1, 2010, through March 31, 2011, that were selected because of their greater patient diversity and higher number of adolescent patients.

Highlight for answer:

Adolescent participants (aged 13-17 years) were recruited from 9 pediatric and family medicine clinics in the Group Health system from April 1, 2010, through March 31, 2011. Clinics located in 3 urban areas in Washington State were selected for their greater patient diversity and higher number of adolescent patients.

Obviously, there are numerous ways to edit the original sentence. We provide just one example of many. Perhaps you found an even better way; if so, leave us a comment.

If you’re interested in more practice, check out the full quiz on the AMA Manual of Style website.—Laura King, MA, ELS


To pass the time between stylebook editions, the JAMA Network staff keep an in-house file of little tips, tricks, guidelines, and style changes that have occurred since the last time the manual was published. Here is a small peek inside that file—2 things from this past summer.

The terms multivariable and multivariate are not synonymous, as the entries in the Glossary of Statistical Terms suggest (Chapter 20.9, page 881 in the print). To be accurate, multivariable refers to multiple predictors (independent variables) for a single outcome (dependent variable). Multivariate refers to 1 or more independent variables for multiple outcomes. (This update was implemented June 1, 2014.)

Cross-section, as a verb or adjective should be capped in titles as Cross-section; cross section as a noun should be capped in titles as Cross Section. (This update was implemented August 4, 2014).—Brenda Gregoline, with help from John McFadden

Lies and Statistics

Check out this post from Skeptical Scalpel about uncool tricks with statistical graphs. Editors beware!—Brenda Gregoline, ELS



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

Quiz Bowl: Editing and Proofreading Marks

tr, swk, wf, lc.

No, the vowel keys haven’t fallen off my laptop keyboard. Those are just a few examples from this month’s quiz on editing and proofreading marks. Although most editing and proofreading are now performed electronically, corrections still sometimes need to be marked on printed manuscripts and typeset copy. Because of this, editors need to be able to identify and use correct editing and proofreading marks.

Although most editors are familiar with marks such as stet, for let it stand, and Au?, for author query, some of the other editing and proofreading marks can occasionally cause confusion. This month’s AMA Manual of Style quiz offers a sampling of these marks to test your knowledge.

Included in the quiz are the meanings of the vowelless list above: tr, swk, wf, lc.

Highlight for the meanings of these marks: tr, transpose; swk, set when known; wf, wrong font; lc, lowercase.

To test your knowledge of additional editing and proofreading marks, check out this month’s quiz at—Laura King, MA, ELS

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

Quiz Bowl: Editing Prose

You asked and we listened! This month’s style quiz once again gives users the chance to practice their editing skills in a more in-depth manner. Previous quizzes on prose editing, as well as editing figures and tables, aimed to fill this need, but you still want more. So, here you go.

This month’s quiz is a full paragraph that requires editing to eliminate usage and style errors. Below is the first sentence of the paragraph. See if you can identify the problems.

We report a young patient who presented with dysphagia caused by a right aortic arch, aberrant left subclavian artery, and associated Kommerell’s diverticulum.

Highlight for answer:  We describe a young patient who presented with dysphagia caused by a right aortic arch, aberrant left subclavian artery, and associated Kommerell diverticulum.

According to the AMA Manual of Style, both patients and cases are described; only cases are reported (§11.1, Correct and Preferred Usage of Common Words and Phrases, pp 381-405 in print). In addition, the nonpossessive form should be used for eponymous terms (§16.2, Nonpossessive Form, pp 778-780 in print).

If you’re interested in more practice, check out the full quiz, as well as the Prose Editing 1, Practice Editing Tables, and Figures quizzes, on the AMA Manual of Style website.

And if there are any other quizzes you want to see, just ask. We promise we’ll listen.—Laura King, MA, ELS