abbreviations

Welcome the 11th Edition of the AMA Manual of Style!

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We are pleased to announce the 11th edition of the AMA Manual of Style, now live at https://www.amamanualofstyle.com/ and shipping in hardcover in a few days.

The manual has been thoroughly updated, including comprehensive guidance on reference citations (including how to cite journal articles, books, reports, websites, databases, social media, and more), an expanded chapter on data display (for the first time in full color), a completely up-to-date chapter on ethical and legal issues (covering everything from authorship and open access to corrections and intellectual property), and updated guidance on usage (from patient-first language and terms to avoid to preferred spelling and standards for sociodemographic descriptors).

The section on nomenclature has undergone thorough review and updating, covering many topics from genetics and organisms to drugs and radiology.

The statistics and study design chapter has been extensively expanded, with more examples of usage and terms that link to a related glossary.

Chapters on grammar, punctuation, abbreviations, capitalization, manuscript preparation, and editing feature refreshed examples and new entries (such as allowance of the “singular they”).

The nearly 1200-page book is enriched by a variety of online features. For example, regular updates to address changes in style or policies will be featured in the Updates section. Any corrections will be made online so that you are always looking at the latest guidelines as you use the manual.

New quizzes will be posted to help new or continuing users learn to master the finer points of AMA style, and the units of measure calculator offers easy conversions between the SI system and conventional units, as well as the metric system.

We welcome questions and comments on the manual: write to stylemanual@jamanetwork.org or find us on Twitter (@AMAManual). We look forward to engaging with you. –Stacy Christiansen, for the AMA Manual of Style Committee

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

Quiz Bowl: Geographic Abbreviations

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Are you in town to watch the Chicago Cubs play the Saint Louis Cardinals, the St. Louis Cardinals, or the St Louis Cardinals? Are they playing at 1060 West Addison St, 1060 W. Addison St., or 1060 W Addison St? Is that at the corner of Addison and Clark Sts, Addison and Clark Streets, or Addison and Clark streets? Knowing when and how to abbreviate geographic terms can be tricky. That’s why this month’s AMA Manual of Style quiz offers practice and tips on how to more easily tread the winding road of geographic abbreviations style. Ready to start the journey? Here we go!

How would you edit the following:

Reprint requests should be addressed to Margaret Smith, MD, MPH, 515 North State Street, Room 22202, Chicago, IL 60654

Use your mouse to highlight the text box for the answer:

Reprint requests should be addressed to Margaret Smith, MD, MPH, 515 N State St, Room 22202, Chicago, IL 60654

When complete local addresses are given, compass directions (in this example, N for North) and street designators (in this example, St for Street) should be abbreviated. Room is never abbreviated (§14.4, Local Addresses, pp 449-450 in print).

And for the record, the Chicago Cubs play the St Louis Cardinals at 1060 W Addison St, which is at the corner of Addison and Clark streets.—Laura King, MA, ELS

Questions From Users of the Manual

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Q: I am writing a manuscript in which I want to include the dates that a list of products were first marketed. The database from which I got the information is a subscriber-only database. This seems to be the only place that has the information I want to use. Are such subscriber-only databases allowable to include in a reference list?

A: This question was one we had to address when working on the chapter on reference citation style and the answer we decided on was YES, these may be included in a reference list. (We did not address it specifically for a subscriber-only database, but this question also arises with reference to journal articles that are password-protected/available only to subscribers.) The rationale was 2-fold. First, if there is another place that the information can be obtained that is not behind a “wall,” then of course you might want to consider using that reference instead of the one that is not easily available to all. But, as you indicated in your case, sometimes there is no “free” site for the information you want to reference, and it’s important to acknowledge your source—even if access to it is limited. Second, thinking back to the days before people were citing much online material (and those days were not that long ago, were they?), reference lists frequently cited books that might be out of print or other sources that might not allow easy access. This doesn’t seem a reason not to include the material, even though it might be an annoyance to online readers to find that the source is not freely available, so YES.

Q: How would you cite a webinar?

A: I would extrapolate from the style recommended for citing an audio presentation:

Christiansen S. Medical copyediting with AMA style [webinar]. December 15, 2011.  http://www.copyediting.com.  Accessed April 6, 2012.

Q: In section 14.12, you state “Use the abbreviation [of units of time] only in a virgule construction and in tables and line art.” Does this mandate the use or merely allow the use of these abbreviations in these instances?

A: The answer is short. It does not mandate so much as allow, although units of measure are almost always abbreviated in column heads and stubs in tables and on axes in line art in our journals because of space considerations.—Cheryl Iverson, MA

 

Cheat Sheet for Abbreviations Style

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Abbreviations are a convenience, a time saver, a space saver, and a way of avoiding the possibility of misspelling words. However, a price can be paid for their use. Abbreviations are sometimes not understood. They can be misread, or are interpreted incorrectly. … The person who uses an abbreviation must take responsibility for making sure that it is properly interpreted.—Neil M. Davis1

Abbreviations are used widely in medical articles, and great care should be taken to provide expansions that define these abbreviations. The AMA Manual of Style includes a straightforward rule regarding the use of abbreviations: Define abbreviations at first mention by providing the expanded term first, followed by the abbreviation in parentheses, and the abbreviation is used thereafter.

But for every rule, there are exceptions.

Some Exceptions:

• Avoid creating abbreviations for terms that are easy to spell out and do not take up a lot of space. For example, it is not advisable to abbreviate “catheter ablation” as “CA” or “immune response” as “IR.” Also, avoid using too many abbreviations in any one article.

• If a term is better known as an abbreviation, provide the abbreviation first with the definition following in parentheses. “The TUNEL (terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick-end labeling) staining assay was carried out using an apoptosis detection kit.”

• It is inelegant to begin sentences with abbreviations, unless the expansion is so unwieldy that using the abbreviation makes sense. The previous example, TUNEL, also works here. Rather than begin a sentence with the cumbersome expansion, it is acceptable to begin the sentence with the abbreviation TUNEL.

• Abbreviations should not be introduced in headings. If an abbreviation is being used for the first time in a heading, expand the abbreviation in the heading; then, at first mention in the running text after the heading, expand the abbreviation again, with the abbreviation following in parentheses. Use the abbreviation thereafter.

• Some very common abbreviations do not require expanding at first mention, such as AIDS, TNM, UV, and CD-ROM. A complete list of these abbreviations is provided in section 14.11, with those that do not require expansion denoted by an asterisk.

• The efficiency of using an abbreviation is lost if the abbreviation is used only one time, so as a rule of thumb, introduce an abbreviation only if it is used at least 2 or 3 times.

Items of Note:

• Tables, figures, and abstracts are treated as separate items from the text, so abbreviated terms must be reexpanded in each of these items.

• Use the appropriate article (a or an) before an abbreviation according to the sound following the article (eg, a UN resolution, an HMO plan).

• Use a lowercase s (and no apostrophe) when making abbreviations plural (eg, NSAIDs).—Lauren B. Fischer

1. Davis NM. MEDical ABBREViations: 28,000 Conveniences at the Expense of Communication and Safety. 13th ed. Warminster, PA: Neil M Davis Associates; 2007:1.

Abbreviation Nation

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Of the reference books I use while editing the Archives journals, my favorite by far is MEDical ABBREViations: 28,000 Conveniences at the Expense of Communication and Safety, 13th Edition, by Neil M. Davis. Not only does it have the most wonderfully snarky title I’ve ever seen on a reference book, but it is the Great Decoder, the book that allows me to make sense of the myriad abbreviations I run across in my daily work.

As much as we are a nation of people who speak largely in cliches and mixed metaphors (I will save my rant about the overused and incorrect “magic bullet” for another day), we are a nation of overabbreviators. The number of organizations that are known by their abbreviation are too many to quantify (NFL, AMA, NORAD). We put out APBs, send out CVs, take our OTC meds, surf our Macs and PCs, and occasionally go AWOL. But when you think about it, do these mean anything? A National Football League is a thing. An NFL is not. What about an AC? Is it an air conditioner? An alternating current? Atlantic City? Though sometimes context can tell us what an abbreviation means, just as often it cannot, and it’s my job to sort these out.

As someone who previously tried to argue that texting is a valid and efficient method of communicating, it may seem hypocritical for me to do a mental fist pump every time I read Mr Davis’ snappy title, but I do. It’s because for every abbreviation that I find easily in my AMA Manual of Style or my MED ABBREV, there are so many that I must ask authors about. This worries me, because I don’t think authors would put these in their articles if they weren’t  routinely used. And though they and their colleagues and most of the American medical community may know exactly what they mean, will readers in Zimbabwe, Thailand, or Argentina? Those readers may have their own set of metaphors, jargon, and abbreviations that makes perfect sense to them. Or they may be students who don’t come across them every day. What happens when we let them slide, or when a journal doesn’t have finicky, know-it-all editors to question them? I worry that it will make journals less accessible, and that it will make medical discourse less accessible. I hate the idea of a medical student somewhere in the world not being able to use one of our articles in his research because I didn’t feel like finding out what something means. And believe me, sometimes I don’t feel like it. But I know I must be persistent, as annoying as it feels to harass a busy professional about something that seems so trivial. And that medical student out there better appreciate it.—Roya Khatiblou, MA