Author: amastyleinsider

Option, Alternative, Alternate

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Alternate means “one after the other,” whereas alternative means “one instead of the other”1—and option and alternative are essentially the same thing. Easy peasy, no?

Well, no. At least not quite.

Although few writers would incorrectly use alternative in place of alternate in the sense of “one after the other,” there are subtle differences between these words—and between option and alternative, as well—when they are used in other senses. The potential for confusion is readily apparent when one considers, for example, that option has been defined as “something that may be chosen”2(p871); alternative as “one of two or more things, courses, or propositions to be chosen”2(p37); and alternate as “one that substitutes for or alternates with another”.2(p37) And that’s considering only the use of these words as nouns. As an adjective, alternative has been defined as “offering or expressing a choice” and alternate as “constituting an alternative.”2(p37)

So—is there a way through this thicket?

Option and choice are usually considered interchangeable, but an alternative is an option or choice that stands “instead of the other.”1 Thus, a person faced with numerous options (choices) will always have one more option than alternatives.3 (Some authorities have proposed that alternative should be used only when no more than 2 choices are available. However, few writers observe this distinction.3,4) For example, a diner presented with a dessert menu that lists 4 desserts will—assuming a 1-dessert limit—have 4 options (ie, choices) but only 3 alternatives. Furthermore, it is usually assumed that one of the options will be the original or preferred one, to which the others are alternatives. For example, on that dessert menu, the red velvet cake, tiramisu, and crème brûlée might be alternatives to that triple fudge ganache lava brownie that one has been ogling, in the event that the server comes back with the sad news that the brownie has apparently been everyone else’s first choice as well.

But things get a bit fuzzy when it comes to the choice between alternative and alternate. As suggested above, these words have acquired meanings that are quite close. When a distinction is made, it would seem to hinge on whether a degree of compulsion is in play, with alternative preferred when such compulsion is not present. For example, a person selected to serve as an alternate juror has little choice in the matter; similarly, whereas a person planning a trip might well map out several alternative routes, the same person faced with an unexpected road closure is forced to take an alternate route.5 And, although option and choice can be used interchangeably, alternative has a bit more nuance than choice, suggesting “adequacy for some purpose.”4 Alternative also can suggest a “compulsion to choose”4—although in this case the compulsion is to choose between alternatives (eg, “The alternatives are liberty and death,”4) rather than, as is the case with alternate, a compulsion or duty to serve in place of another (eg, alternate juror, alternate batter).

In practice, although some authorities still advocate maintaining the traditional distinctions between alternative and alternate, actual usage is changing rapidly, and alternative is now often used when a noun is called for and alternate when an adjective is called for.6 However, a big nota bene for medical writers: alternative is used as an adjective in medical contexts when referring to nonallopathic medicine, treatments, or therapies, such as acupuncture, homeopathy, etc. So, the adjective alternate is certainly preferred when referring, for example, to different allopathic treatment choices available to a patient (eg, “the consulting physician recommended surgery but also proposed 3 alternate approaches”).

The bottom line:

● Looking for a word that indicates “one after the other”?1 Use alternate (eg, “Alternate smiles and frowns, both insincere.”7)

● An alternative is by definition an alternative to something else—usually a preferred choice or original plan of action—so one will always have 1 more option than alternatives.

● Although some authorities still maintain the traditional distinctions between alternative and alternate, usage is changing rapidly, and alternative is now often used when a noun is called for and alternate when an adjective is called for—but in medical contexts, the adjective alternative is often used in reference to nonallopathic medicine, treatments, or therapies.—Phil Sefton, ELS

1. Alternate/Alternative. In: O’Conner PT. Woe Is I: The Grammarphobe’s Guide to Better English in Plain English. 3rd ed. New York, NY: Riverhead Books; 2009:88.

2. Merriam-Webster’s Collegiate Dictionary. 11th ed. Springfield, MA: Merriam-Webster Inc; 2003.

3. Fogarty M. Quick and Dirty Tips: “Alternate” Versus “Alternative.” Grammar Girl website. http://grammar.quickanddirtytips.com/alternate-versus-alternative.aspx. Accessed January 16, 2013.

4. Alternate; alternative. In: Garner BA. The Oxford Dictionary of American Usage and Style. New York, NY: Oxford University Press; 2000:18.

5. Alternate vs. alternative. Grammarist website. http://www.grammarist.com/usage/alternate-alternative/. Accessed March 27, 2013.

6. Alternate, alternative. English Forums website. http://www.englishforums.com/English/AlternateVsAlternative?bzxvg/post.htm. Accessed January 16, 2013.

7. The Compact Oxford English Dictionary. 2nd ed. Oxford, England: Oxford University Press; 1991:41.

Questions From Users of the Manual

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Q: I have sometimes seen myalgia written in its plural form, myalgias. I would no sooner write myalgias than I would write bone losses.  What is your opinion on this?

A: I took a look at both Webster’s 11th and Dorland’s, our principal dictionaries, and both of them define myalgia as “pain in a muscle or muscles.” I think that this is indication that the singular covers both one and many. So, in short, I am in agreement with your reasoning and would use the singular. I also consulted the author of our Correct and Preferred Usage chapter, and she agrees–she feels the plural form is more “jargon-y.”

Q: In the sentence below, would you change frequently occurring to common?

Constipation is a frequently occurring symptom that can result from dehydration, use of certain medications, prolonged bed rest, lack of physical activity, or mechanical changes resulting from cancer or anticancer therapies.

A:  My instinct is that these 2 are not identical. The notion of “frequently occurring” could apply to frequency in a single individual, I think, whereas “common” signifies that it is something that may be experienced by many people (without any regard to its frequency). Roxanne Young, the author of our Correct and Preferred Usage chapter, concurs. You did not say why you were thinking of making the change, but the opinion from The JAMA Network Journals is that we would retain the distinction, however subtle, between frequently occurring and common.

Q: The author instructions in a journal to which I am about to submit a paper refers to the “standard abbreviations within the AMA 10th edition (see pages 502-525).” I notice that a small number of these abbreviations are followed by an asterisk, indicating that they do not require expansion at first mention. Are these the only “standard abbreviations” to which the guidelines might refer? Does the AMA Manual of Style contain other lists that include such “asterisked” items?

A:  The list on pages 502-525 (in section 14.11 for those who use the online manual and don’t find page numbers helpful), does indeed contain a few items that have an asterisk to indicate that they do not need to be expanded at first mention. [NOTE:  As of July 27, 2011, an asterisk was also added after CI (confidence interval). See this in the online Updates.] The page numbers 502 through 525 also include the list in 14.12 , Units of Measure. There are many other little lists of abbreviations throughout the manual, but these lists, in the Abbreviations chapter, are the ones most likely to be intended by the instructions for authors you cite.—Cheryl Iverson, MA

Quiz Bowl: Author-Editor Relationship

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There have been some famous, even notorious, author-editor relationships: Charles Dickens and Edward Bulwer-Lytton, Ted Hughes and Sylvia Plath, Raymond Carver and Gordon Lish. This month’s quiz takes us on a tour of some of these fruitful and fractious relationships as a means of exploring effective ways for editors to handle issues with authors. The following is an example from this month’s quiz.

Vladimir Nabokov, author of Lolita, notoriously and wittily disdained editors. In a 1967 interview in The Paris Review, he said, “By ‘editor’ I suppose you mean proofreader. Among these I have known limpid creatures of limitless tact and tenderness who would discuss with me a semicolon as if it were a point of honor—which, indeed, a point of art often is. But I have also come across a few pompous avuncular brutes who would attempt to “make suggestions” which I countered with a thunderous ‘stet!’”1

What is the best way for editors to communicate with authors who balk at the suggestions made to improve the manuscript?

a. E-mail the author to tell him/her that all the edits are based on the AMA Manual of Style and therefore not subject to change.

b. Telephone the author to discuss the edits, iterating the rationale and providing resource support for the changes.

c. Do not respond to the author.

d. Eliminate all the edits and publish the paper as the author originally submitted it.

What would you do? Here’s our advice (use your mouse to highlight the text box):

Telephone the author to discuss the edits, iterating the rationale and providing resource support for the changes.

Usually, an author’s insistence to overrule all editorial changes is a knee-jerk reaction to extensive editing. Most authors are aware of the editing process, although some need to be guided gently through it. Communicating with the author and explaining the reason for the changes (as well as providing resource support when necessary) can often defuse a volatile situation.—Laura King, MA, ELS

 

  1. Gold H, interviewer. Vladimir Nabokov, The Art of Fiction No. 40. The Paris Review. http://www.theparisreview.org/interviews/4310/the-art-of-fiction-no-40-vladimir-nabokov. Accessed February 8, 2013.

Aegis

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“Recognizing that the genetic contribution to health disparities is likely to be relatively limited is not the only reason to question the wisdom of promoting genetic research under the aegis of health disparities.”1

“In several examples published under the aegis of the [Agency for Healthcare Research and Quality], the benefit side rests on the data from randomized controlled trials….”2

“[T]his definition and associated regulations have become de facto rules for US academic and other research institutions and are applied to any work done by their employees or under their aegis regardless of the source of funding.”3

While somewhat infrequently encountered in medical writing, aegis is occasionally used in content related to health policy, institutional oversight, or the conduct of research. It also is occasionally used to refer to a journal’s vouching for the validity of data or other findings published in its pages; when such validity is called into question, a journal may issue a full retraction or simply “withdraw aegis,” ie, issue a statement to the effect that the journal is no longer responsible for the data.4

In its original sense, aegis (Greek aigis [goatskin]) referred to the shield or protective cloak worn by Zeus or Athena in the myths of ancient Greece.5 In the centuries since, the word has by association come to be used idiomatically to indicate defense (“Feeling is the aegis of enthusiasts and fools.”6) or guidance or influence (“They made their valuable individual contributions, but under the Ellington aegis they found themselves constantly enriched musically.”6). Similarly, the word is perhaps most often used in the construction “under the aegis of” to express patronage or sponsorship (“under the aegis of the museum”) and, especially, protection (“a child whose welfare is now under the aegis of the courts”).5

All of which is perfectly comforting. However, the classical roots of the word are far less benign. Whereas aegis-like shields appear in Egyptian, Nubian, and Norse mythology and art,7,8 the most elaborate account of the origins and attributes of the aegis comes, as suggested above, from the narratives of ancient Greek mythology and literature, in which it is consistently depicted as an object possessing fearsome supernatural power.

In one such narrative, the goat deity Amaltheia suckles the infant Zeus, who then—in the curiously detached manner so frequently encountered in mythological accounts—breaks off her horns and flays her hide. From one of her horns Zeus fashions the cornucopia, or horn of plenty; from her hide, he fashions the shield or cloak that would come to be called the aegis, which he then wears, on the counsel of an oracle, into battle against the marauding Titans.9 However, in the hands of Zeus, king of the gods, the aegis is more than a protective device; when in his wrath he shakes the aegis from his perch atop Mount Olympus, thunder crashes, bolts of lightning slash the sky, and fierce storms devastate the land.10 Moreover, in the Iliad, Homer describes the device as the “tempestuous terrible aegis, shaggy [and] conspicuous… given to Zeus to the terror of mortals.”11

But the aegis is associated with deities other than Zeus. In the Iliad, for example, Zeus lends the aegis to Apollo, who wields it to push his enemies back to their ships12; in other accounts, Zeus lends the aegis to his daughter, Athena, goddess of war,12 or presents it to Athena after his conquest of the Titans.9 In the most colorful account, Zeus swallows his wife, Metis, whole—after which Athena is born from Zeus’ head, emerging fully formed and bearing the aegis and other weapons of war.13 Regardless of how Athena comes to possess the aegis, however, in her hands it becomes more formidable still. For example, in the Iliad Homer reverently describes the aegis as no mere goatskin but rather as “ageless and immortal,” worn by “bright-eyed Athene” and adorned with tassels of the purest gold12; moreover, elsewhere in the Iliad he describes the aegis as a dramatic golden cloak fashioned by Hephaistos, god of fire and metalwork,14 to resemble a scaly skin like that of a snake, linked and fringed with writhing serpents, and bearing in its center the severed head of the Gorgon Medusa, eyes rolling and scalp also bristling with serpents.11

Charming as this may be, given the provenance of the word and the fell associations that come with it, how did aegis, apart from its military associations, come to be used to express defense or protection? Perhaps more puzzling, how did it come to be used to express benevolent guidance, influence, or patronage? A possible clue is that whereas early accounts often depict Athena as cultivated, civilized, urbane, and wise, the economy of ancient Greece was bolstered by military pursuits, and in short order Athena came to be depicted as the goddess of war—although, importantly, her military might was tempered by the cultivation and divine wisdom earlier attributed to her.15 Thus, Athena is sometimes viewed as having 2 sides. The first is characterized as wrathful, tempestuous, and destructive; however, the other is characterized as divinely beneficent and endowed with the inclination and ability to grant the gifts of aid, wisdom, and protection to favored mortals.16 The power of both sides is wielded through the supernatural power of the aegis—hence Homer’s description of the device in the Iliad and its depiction in visual art as inky black or brilliant gold.11,12,16

Interestingly, however, while Athena extends divine beneficence and protection—backed by the wrathfulness also attributed to her—she does not authorize those mortals fortunate enough to come under her favor to act on her behalf. Thus, whereas in current usage aegis is correctly used to express defense, protection, guidance, influence, patronage, or sponsorship, its use to indicate “under the jurisdiction of” is considered incorrect.17 —Phil Sefton, ELS

1. Sankar P, Cho MK, Condit CM, et al. Genetic research and health disparities. JAMA. 2004;291(24):2985-2989.

2. Vandenbroucke JP, Psaty BM. Benefits and risks of drug treatments: how to combine the best evidence on benefits with the best data about adverse effects. JAMA. 2008;300(2):2417-2419.

3. Iverson C, Christiansen S, Flanagin A, et al. AMA Manual of Style: A Guide for Authors and Editors. 10th ed. New York, NY: Oxford University Press; 2007:157.

4. Hammerschmidt DE, Franklin M. The limits and power of peer review. Minn Med.

http://www.minnesotamedicine.com/PastIssues/PastIssues2006/June2006/CommentaryHammerschmidtJune2006/tabid/2527/Default.aspx. June 2006. Accessed February 13, 2013.

5. Aegis. Merriam-Webster’s Collegiate Dictionary. 11th ed. Springfield, MA: Merriam-Webster Inc; 2003:19.

6. Aegis. The Compact Oxford English Dictionary. 2nd ed. Oxford, England: Oxford University Press; 1991:22.

7. Aegis: in Egyptian and Nubian mythology. Museum of Learning Web site.

http://www.museumstuff.com/learn/topics/aegis::sub::In_Egyptian_And_Nubian_Mythology. Accessed February 15, 2011. 8. Aegis: in Norse mythology. Museum of Learning Web site. http://www.museumstuff.com/learn/topics/aegis::sub::In_Norse_Mythology. Accessed February 15, 2011.

9. Amaltheia. Theoi Project Web site. http://www.theoi.com/Ther/AixAmaltheia.html. Accessed February 13, 2013.

10. Zeus. Theoi Project website. http://www.theoi.com/Olympios/Zeus.html. Accessed February 13, 2013.

11. Hephaistos Works 2. Theoi Greek Mythology Web site. http://www.theoi.com/Olympios/HephaistosWorks2.html. Accessed February 13, 2013.

12. Teleporter: aegis mound. Entropia Planets Web site. http://www.entropiaplanets.com/wiki/Teleporter:Aegis_Mound. Accessed February 13, 2013.

13. Athena. Theoi Project Web site. http://www.theoi.com/Olympios/Athena.html. Accessed February 13, 2013.

14. Hephaistos. Theoi Project Web site. http://www.theoi.com/Olympios/Hephaistos.html. Accessed February 13, 2013.

15. Athena. Encyclopedia Britannica Online. http://www.britannica.com/EBchecked/topic/40681/Athena?anchor+ref85160. Accessed February 13, 2013.

16. Deacy S, Villing A. What was the colour of Athena’s aegis? J Hellenic Stud. 2009;129:111-129. http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=6779888. Accessed February 13, 2013.

17. Bernstein TM. The Careful Writer: A Modern Guide to English Usage. New York, NY: Athaneum; 1985:29.

Questions From Users of the Manual

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Q: What is the difference between “percent” and “percentage”?

A: We regard “percent” as being a unit (equivalent to “kilograms”) and “percentage” as being a description of something that is measured in percent (equivalent to “weight”). As a rule of thumb, this would mean that “percent” (or the percent sign) would usually be used after a number: “In 10% of participants…” When discussing these values more broadly, “percentage” would be appropriate: “The percentages in Table 4 are from the study results in 2007.”

Q: When a percentage is associated with a drug, does it belong before the drug name or after it? The examples used in sections 15.4.9 and 15.4.10 seem to contradict each other.

A: Typically, the percentage would follow the drug name, as described in section 15.4.10: metronidazole lotion, 0.75%. The example in section 15.4.9 is slightly different as it describes the percentages of the components in a single product: “an artificial tear product containing 0.42% hydroxyethylcellulose and 1.67% povidone.”

Q: The 10th edition refers to both “press release” and “news release.” Are these used interchangeably or is there a distinction?

A: We consider these interchangeable terms, but in the next edition we may use “news release” exclusively because information is distributed well beyond print media.

Q: Do you drop the periods in the abbreviation LLC (limited liability company)? I see that you recommend dropping the period after Co (company) and Inc (incorporated) and wondered if this would be treated similarly.

A: Yes.

Q: Your manual (p 342) recommends that a colon not be used after because or forms of the verb include. Does this recommendation include situations in which the word include precedes a bulleted list?

A: Yes, it would be applicable whether the copy that follows the verb include precedes a bulleted list or run-in text. The key is that a verb should not be separated from its object or predicate nominative. For example, we would recommend the following:

There are many treatments for skin irritation. The treatment prescribed may include creams, sprays, and gels.

There are many treatments for skin irritation. The treatment prescribed may include

  • creams
  • sprays
  • gels

Another option would be the following:

There are many treatments for skin irritation: creams, sprays, gels.

—Cheryl Iverson, MA

Emergency, Emergent, Urgent

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As I was editing a manuscript on patients undergoing surgery for brain tumors, I came across the sentence, “Patients who required emergency care were admitted to the hospital and classified as needing emergent or urgent surgery.” As I reread the sentence, the terms emergency, emergent, and urgent started to swim before my eyes, each backstroking to take the place of the other. Soon I was reading, “Patients who required urgent care were admitted to the hospital and classified as needing emergency or emergent surgery.” And then, “Patients who required emergent care were admitted to the hospital and classified as needing emergency or urgent surgery.” What was going on? Was my late-night habit of perusing stylebooks and usage guides before bedtime starting to produce side effects (oops, I mean adverse effects)? Was I no longer able to delineate the difference between commonly used medical terms? I had to take action.

Diligent medical copy editor that I am, I turned to my bookshelf, which is chock full of dictionaries and grammar, usage, and editing books. Now I would be able to solve this conundrum. I would take this problem step by step, or rather word by word, and find the resolution. Here’s what I found:

Emergency

Stedman’s Medical Dictionary1 defines emergency as “an unexpected development or happening; a sudden need for action.”

Dorland’s Illustrated Medical Dictionary2 defines emergency as “an unlooked for or sudden occurrence, often dangerous, such as an accident or an urgent or pressing need.”

Merriam-Webster’s Collegiate Dictionary3 defines emergency as “an unforeseen combination of circumstances or the resulting state that calls for immediate action.”

Consensus! There’s nothing a copy editor likes better.

Resolution: An emergency is basically an unexpected event that requires immediate action.

Emergent

Dorland’s defines emergent first as “pertaining to an emergency” and second as “coming into being through consecutive stages of development, as in emergent evolution.”

Stedman’s omits the definition stemming from the term emergency and defines emergent first as “arising suddenly and unexpectedly, calling for quick judgment and prompt action” and second as “coming out; leaving a cavity or other part.”

Merriam-Webster’s defines emergent as “arising unexpectedly” or “calling for prompt action.”

This one’s a little trickier. Dorland’s relates the term emergent to emergency and Stedman’s and Webster’s simply define emergent as the adjectival form of the noun emergency. So, is there a difference between these 2 words or are they synonymous? It was time to reach deeper into my bookshelf.

I first turned to the classic text A Dictionary of Modern English Usage by H. W. Fowler.4 I knew Fowler wouldn’t let me down. Fowler’s entry on emergence and emergency reads as follows, “The two are now completely differentiated, -ce meaning emerging or coming into notice, and -cy meaning a juncture that has arisen, especially one that calls for prompt measures.”

After some additional research, I found this entry in Common Errors in English Usage by Paul Brians5: “The error of considering ‘emergent’ to be the adjectival form of ‘emergency’ is common only in medical writing, but it is becoming widespread. ‘Emergent’ properly means ‘emerging’ and normally refers to events that are just beginning—barely noticeable rather than catastrophic. ‘Emergency’ is an adjective as well as a noun, so rather than writing ‘emergent care,’ use the homely ‘emergency care.’”

Eureka! Emergent means beginning to arise and emergency means arising unexpectedly.

Resolution: Use emergent to mean emerging (as in Dorland’s section definition of “coming into being through consecutive stages of development, as in emergent evolution”) and emergency to mean an unexpected event that calls for immediate attention.

But then what about urgent?

Urgent

Neither Dorland’s nor Stedman’s defines the term urgent.

Merriam-Webster’s Collegiate Dictionary defines urgent as “calling for immediate action.”

So, can urgent and emergency be used interchangeably? The Children’s Hospital of Wisconsin website provides a list of surgery types. It groups urgent or emergency surgery and defines it as surgery “done in response to an urgent medical need, such as the correction of a life-threatening congenital heart malformation or the repair of injured internal organs after an automobile accident.”6 However, the website Trivology.com states, “There is major difference between elective, urgent, emergency surgery. In urgent surgery we can wait until the patient’s health is unwavering but it has to be performed in 1-2 days. But emergency surgery needs to be performed without any impediment otherwise there will be colossal risk to patient’s life.”7

Therefore, in medical editing, be careful of changing emergency to urgent because emergency means immediate attention is required and urgent indicates quick but not immediate action is required. There is no such thing as emergent surgery unless you mean surgery that is just beginning.

Resolution: Although emergent and urgent both indicate calls for swift action, urgent is more, well, urgent.

Well, there you have it. I guess that original sentence I was editing makes sense after all. “Patients who required emergency surgery [immediate surgery because of the unforeseen nature of the incident] were admitted to the hospital and classified as needing emergent [with a few hours] or urgent [within 24 hours] care.”— Laura King, MA, ELS (January 2013)

1. Stedman’s Medical Dictionary. 26th ed. Baltimore, MD: Williams & Wilkins; 1995.

2. Dorland’s Illustrated Medical Dictionary. 32nd ed. Philadelphia, PA: Elsevier Saunders; 2012.

3. Merriam-Webster’s Collegiate Dictionary. 11th ed. Springfield, MA: Merriam-Webster Inc; 2003.

4. Fowler HW. A Dictionary of Modern English Usage. 2nd ed. Oxford, England: Oxford University Press; 1965.

5. Brians P. Common Errors in English Usage. 2nd ed. Sherwood, OR: Williams James & Co; 2008.

6. The Children’s Hospital of Wisconsin website. Types of Surgery. http://www.chw.org/display/PPF/DocID/22082/router.asp. Accessed January 10, 2013.

7. Trivology.com. http://www.trivology.com/articles/209/what-is-elective-surgery.html. Accessed January 10, 2013.

Quiz Bowl: Creating Tables and Figures

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Have you ever been editing and suddenly experienced déjà-vu? You know, that feeling that you’ve read the material before. And I don’t mean several weeks or even days ago. I mean really recently. Don’t worry. You’re probably not suffering from posttraumatic editing syndrome. Often authors duplicate material by presenting it in both table and text forms. This is a no-no. As the AMA Manual of Style states, “The same data usually should not be duplicated in a table and a figure or in the text” (§4, Visual Presentation of Data, p 81 in print). Of course, some overlap is to be expected, but extensive duplication of data in tables and text is a waste of space and the reader’s time.

This month’s style quiz on creating tables and figures asks the user to create a figure and a table from text. There are only 2 exercises, so I’m not going to give 1 away here. Instead, here’s a bonus exercise for you to try.

Directions: Use the information in the following paragraph to create a table that can replace the text. Refer to section 4.1 of the AMA Manual of Style.

In a multivariable model of communication attributes associated with parental peace of mind (controlled for diagnostic category, time since diagnosis, child’s age, parent’s education, parent’s race/ethnicity, physician-rated prognosis, and degree of discrepancy between parent-rated and physician-rated prognosis; adjusted for clustering by physician), the odds ratios (95% confidence intervals) were as follows: 2.05 (1.14-3.70) for parent recalled receiving more extensive prognostic disclosure, 2.54 (1.11-5.79) for parent rated information received as high quality, and 6.65 (1.47-30.02) for parent had a greater sense of trust in physician.

Now, of course, there are several ways to reformat this sentence into a table, but here’s what we published (it was table 4 in this article). (Click for bigness.)

Figure

If you want more experience reformatting text into tables or figures, take this month’s quiz at www.amamanualofstyle.com—Laura King, MA, ELS

Ex Libris: Grammar Girl’s 101 Words Every High School Graduate Needs to Know

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Last month’s Ex Libris column reviewed Grammar Girl’s 101 Misused Words You’ll Never Confuse Again, the first in a series of 4 titles in the 101 Words series by Grammar Girl alter ego Mignon Fogarty (http://www.quickanddirtytips.com/). This month’s column reviews Grammar Girl’s 101 Words Every High School Graduate Needs to Know. Just as Grammar Girl soared to the aid of grammarians in their quest to avoid misusing commonly confused words, so too does she come to the rescue of recent high school graduates (and those not so recent graduates) who want to appear educated and erudite. As Fogarty writes in her introduction, “You may or may not have been taught these words in high school, but they’ll serve you well from here on out. Use them in your college entrance essays or during job interviews to show that you’re well-read and well-spoken.”

Although this book could easily have become 1001 Words Every High School Graduate Needs to Know, Fogarty wisely narrows her list to 4 to 6 words from each letter of the alphabet from a variety of disciplines (eg, politics, science, and economics). As with 101 Misused Words You’ll Never Confuse Again, 101 Words Every High School Graduate Needs to Know is a fun-to-read and easy-to-use paperback that is formatted as a glossary, with words arranged alphabetically and most entries only 1-page long. Each entry includes a quotation illustrating the correct usage of the word in question from such historical and cultural icons as Harry Truman, Andy Warhol, and Homer Simpson. For example, in the entry on Tenacious, Fogarty quotes the Belgian philosopher Paul De Man, “Metaphors are much more tenacious than facts.”

For users of the AMA Manual of Style, a few entries are particularly useful because they directly relate to the guidelines outlined in the manual (www.amamanualofstyle.com). For the term chronic, Fogarty writes, “In medicine, the opposite of a chronic disease (something that comes on slowly and will progress over a long time) is an acute disease (something that comes on suddenly, is severe, and is likely to end). For example, type II diabetes is a chronic condition and a stroke is an acute condition.” This supports the entry from the AMA Manual of Style, which states that the terms acute and chronic “are most often preferred for descriptions of symptoms, conditions, or diseases; they refer to duration, not severity.”

For the term malignant, Fogarty writes, “Malignant diseases and situations are aggressive, out of control, and dangerous. In medicine, only malignant tumors are called cancer; less invasive tumors are called benign.” In the AMA Manual of Style, the usage note for malignant reads, “When referring to a specific tumor, use malignant neoplasm or malignant tumor rather than malignancy. Malignancy refers to the quality of being malignant.”

Fogarty also defines the term correlation and provides the useful tip, “A common scientific phrase is correlation does not equal causation—a reminder that studies often find that events happen at the same time without proving that one causes the other.” This is similar to the AMA Manual of Style’s definition of the term correlation as the “description of the strength of an association among 2 or more variables, each of which has been sampled by means of a representative or naturalistic method from a population of interest. … There are many reasons why 2 variables may be correlated, and thus correlation alone does not prove causation.”

Finally, both Fogarty and the AMA Manual of Style describe the difference between the terms quantitative and qualitative. Fogarty writes, “People often confuse quantitative and qualitative, in part because qualitative results can be presented in ways that makes them look quantitative, for example, when researchers ask qualitative questions, but have subjects answer on numerical scales: How happy were you to see the dolphins? Answer on a scale from 1 to 10.” According to the AMA Manual of Style, qualitative data is “data that fit into discrete categories according to their attributes, such as nominal or ordinal data, as opposed to quantitative data,” which is “data in numerical quantities such as continuous data or counts (as opposed to qualitative data).”

Although Grammar Girl’s 101 Words Every High School Graduate Needs to Know was written with a general audience in mind, much can be gained by the medical editor reader. Not only the entries on specific medical words but also the entries on general terms commonly encountered in scientific writing, such as ad hoc, epitome, jargon, kilometer, and mandate, are helpful for the editor.—Laura King, MA, ELS

Questions From Users of the Manual

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Q: I have a question about biologic vs biological and physiologic and physiological. How do I know which version to use?

A: It may have been “hidden,” but the tricky “-ic/-ical” question is addressed in the manual on  page 396 (section 11.1). This section specifically addresses biologic/biological and physiologic/physiological, 2 pairs of words where the different endings may have a different meaning.

Q: In section 8.3.1, why do you show a hyphen in “The rash was a treatment-related adverse event.” but not in “The adverse event was treatement related.”?

A: The policy of hyphenating a compound when it  precedes the noun it modifies but not when it follows comes up in many examples in the Hyphens section of the manual. The rationale for this policy is based on easier comprehension. Much may precede and modify a noun. The use of hyphenation (as in “treatment-related adverse event”) helps make the relationships of the words that precede the noun clearer and easier for a reader to understand. In the case in which this word string follows the noun, the hyphenation is not required for easier understanding (“The adverse event was treatment related.”) You see this same logic in so many places:

It was a 5-cm distance.

The distance was 5 cm.

He was a well-known author.

The author was well known.

Q: Would it be acceptable to use bit.ly as a way to shorten URLs in references in a scientific article’s reference list?

A: Using bit.ly to shorten URLs in the reference list for a scientific article is probably not consistent with best practices. We do use bit.ly in our style manual tweets, to save space, but the reference list of a scientific article is a different matter. Use of the full URL allows readers to know the original domain name (like nih.gov). We are also not sure how permanently stable a shortened link would be.

NOTE:  The person who inquired noted:  “Regarding shortened URLs and transparency, there is one bright spot for people citing US government publications. The government created its own vanity bit.ly domain, 1.usa.gov.

http://gov20.govfresh.com/usa-gov-adds-1-go-usa-gov-url-shortener-for-civilian-use/.”—Cheryl Iverson, MA

 

Questions From Users of the Manual

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Q: Does the change of footnote symbols from asterisk, dagger, etc (9th edition) to superscript lowercase letters (10th edition) apply not only to tables but also to the title page?

A: No, this change does not apply to the title page. Typically, the only footnotes used on the title page would be the “death dagger” (see section 2.3.2) and the asterisk at the end of the byline if the byline is the name of the group, not all members of which qualify for authorship (see p 15, bottom).

Q: In your information on databases, the link you provide for HUGO no longer links. Do you have the new URL?

A: Yes, since publication of the 10th edition of the manual, the URL for HUGO has changed. The new URL is http://www.genenames.org. We have included this in a new batch of errata posted on the companion website in January 2008 and it will be corrected in the third printing.

Q: In medical writing, is it preferred to spell naive with or without the umlaut over the i?

A: We would follow the latest edition of Webster’s New Collegiate Dictionary. The 11th edition shows that both spellings are equally correct but, in such cases, to maintain uniformity among all the articles in our family of journals, we arbitrarily select the first spelling given: naive. Also, in the 10th edition of our manual (p 422), it indicates that “in general, English words in common usage should be spelled without the diacritical marks.”—Cheryl L. Iverson, MA