frequently asked questions

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Q: I’ve been searching the 10th edition to see where the list of footnote symbols from the previous edition is given and I cannot find it. Is that because the lowercase alphabet letters are now going to replace these symbols, as mentioned on page 91?

A: Yes, almost right. We have changed our policy on using superscript symbols for table footnotes and are now using superscript lowercase letters. There are more of them and they are not so “odd.” However, we are continuing to use the old “footnote symbols” for bottom-of-the-page footnotes (see p 43). We only show 2 here…the asterisk and the dagger…because it is not likely that more would be needed (this is the only type of bottom-of-page footnotes that we use in our journals), but if you were to require more, the “old” list would still apply.

Q: I haven’t been able to locate in the 10th edition the place where it says that the symbols “greater than” and “less than” should not be used in running text. (It’s at the top of p 256 in the ninth edition.)

A: You are correct. We neglected to include that this time, but the policy is the same. The examples on page 399 illustrate this, but having the specific statement would be good. It’s a bit like the policy we have of reserving the use of the hyphen for ranges to within parentheses and in tables (and, of course, in references, for the page ranges) and not using it in running text (P values are another exception). It all has to do with “elegance.”—Cheryl Iverson, MA

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Q: I understand that the second printing of the AMA Manual of Style is now available and that many of the items in the list of Errata on the companion website (www.amamanualofstyle.com) are corrected therein. How can I tell if I have the first or the second printing? Does the second printing have a different ISBN?

A: Yes, the second printing was published in October 2007 and in it the majority of errata listed on the companion website are corrected. You can tell which printing you have by looking at the copyright page of the book (p iv). In the lower left corner of that page is a string of numbers, beginning, on the left, with 9. The number on the far right of that string will indicate the number of the printing. If the last number on the right is a 2, you have the second printing. The ISBN does not change with printings.

Q: Which is correct: “Qvar has similar systemic effects to those of fluticasone” or “Qvar has similar systemic effects as those of fluticasone”?

A: The correct idiomatic form is “similar…to” not “similar…as,” as with “identical…to” rather than “identical…as.” I suspect the use of “as” in this construction comes from a related idiom: “the same as.” You could also rephrase this to “Qvar and fluticasone have similar systemic effects.” or “Qvar has systemic effects similar to those of fluticasone.”

Q: Has the policy on SI units changed? If so, how?

A: Yes. These changes are addressed in detail in section 18.5.10. For laboratory values reported in JAMA Network Journals, factors for converting conventional units to SI units should be provided in the article. In text, the conversion factor should be given once, at first mention of the laboratory value, in parentheses following the conventional unit.

The blood glucose concentration of 126 mg/dL (to convert to millimoles per liter, multiply by 0.055) was used as a criterion for diagnosing diabetes.

For articles in which several laboratory values are reported in the text, the conversion factors may be provided in a paragraph at the end of the “Methods” section. In tables and figures, this information can be provided in the footnote or legend.

Q: Although the 10th edition recommends spelling out state names except in full addresses and the reference list (for location of publishers), I notice that you still show “DC” for District of Columbia. Is this an exception?

A: Yes.

Q: If a state’s full name is spelled out on first mention in running text, per the new style, what do you do when numerous cities in the same state are mentioned in an article? Should the state name be spelled out every time it is mentioned, every time a new city is mentioned, or should the 2-letter postal code be used after the first time the state name is spelled out in running text?

A: The answer will depend on the context. If the article is about cities in a particular state, you might not need to include the state name with the individual cities at all, as it will be clear what the state is, eg, “6 cities in Massachusetts.” If the state name is spelled out at the first mention of each new city, it shouldn’t need to be repeated, unless there are instances in the manuscript of a city that exists in more than 1 state (eg, Springfield, Massachusetts, and Springfield, Illinois).—Cheryl Iverson, MA

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Q: Section 3.12.5 describes how to cite books with editors and translators but there is no example showing how to cite a book with both an editor and an editor in chief. Should only the editor in chief be cited if one is given for a book?

A: No, I would not exclude other editors’ names if an editor in chief is given. You could extrapolate from the example in section 3.12.5 that shows how to cite an editor and a consulting editor. In that example, repeated below, just replace “consulting ed” by “ed in chief.”

Klaassen CD. Principles of toxicology and treatment of poisoning. In: Hardman JG, Limbird LE, eds. Gilman AG, consulting ed. Goodman and Gilman’s The Pharmacological Basis of Therapeutics. 10th ed. New York, NY: McGraw-Hill Book Co; 2001:67-80.

Q: When you cite an online reference that will require a password to access the reference, should you include in the reference citation some indication that access is restricted?

A: We wrestled with this question when preparing the current edition and decided against it because different users would have different access rights.

Q: When citing the same work 2 or more times in a manuscript, do you continue to use the same superscript reference number, or do you use a different superscript reference number and relist the work multiple times in the reference list?

A: It is our style to give a reference one number and to refer to it by that number every time it’s cited. This policy is not stated specifically in the manual and perhaps in the next edition it should be. In the current edition, page 44 discusses the situation in which an author might want to cite different (and specific) page numbers from the same reference. The style used is based on the assumption that a reference number “sticks” throughout a manuscript.

Q: Your manual (pp 22 and 183 in print) advises that clinical trials should be registered and that the URL of the registry and the identifying number should be published as a part of the manuscript. Is this still true if the clinical trial has been terminated?

A: Yes, the identifier should be given even if the clinical trial has been terminated. Anyone who chooses to go to the URL provided will be able to read about the trial and will also see there that it has been terminated.—Cheryl Iverson, MA

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Q: Would you hyphenate “white coat hypertension”?

A: We would follow the latest edition of Webster’s New Collegiate Dictionary. The 11th edition recommends inclusion of a hyphen: white-coat hypertension.

Q: If 2 footnote symbols appear next to each other in a table, should any punctuation be introduced between them?

A: Yes. As with the policy for citation of a reference citation and a footnote symbol side by side (see page 95 in the print), add a comma. So, you might have superscript a,b; or superscript a,c-e.

Q: I would like to know how to cite your 10th edition in the style recommended by the 10th edition.

A: Glad to oblige:

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.

Q: Section 3.10 advises beginning the subtitle of a journal article cited in a reference list with a lowercase letter. Is this true even if the title ends with a question mark?

A: Yes. Here is an example, edited to style:

Mayer AP, Files JA, Ko MG, Blair JE. Do socialized gender differences have a role in mentoring? academic advancement of women in medicine. Mayo Clin Proc. 2008;83(2):204-207.

The same policy would apply if the title were to end with an exclamation point, although those are rare in scholarly article titles!—Cheryl Iverson, MA

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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

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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

 

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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

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Q: What is the source for the statement in section 11.10.5 that “The term sexual preference  should be avoided because it implies a voluntary choice of sexual orientation not supported by the scientific literature”?

A: The source is what is shown as reference 20:  Maggio’s Talking About People:  A Guide to Fair and Accurate Language. This was published by Oryx Press in 1997 and we are not aware of a newer edition.

Q: Is there a list in the manual, or in a source recommended by the manual, as to when it is appropriate to refer to an individual as “Dr”? It is sometimes difficult to know if a non-US degree is equivalent to an MD degree.

A: Great question. We do include a few of these in the manual (eg, MBBS), but you might try Google. It can provide helpful information on various degrees.

Q: Would you use “e-visit” or “E-visit” when it appears at the beginning of a sentence?

A: Based on the advice we give in 10.7 for “e-mail” (use “E-mail” if it appears at the beginning of a sentence), I would use “E-visit” at the start of a sentence.

Q: How do you cite the online AMA Manual of Style?

A:  I would recommend the following, based on 3.15.2 in the manual:

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.  www.amamanualofstyle.com.  Published online 2009.

—Cheryl Iverson, MA

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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

 

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Q: We do not find anything in the manual on how to treat “24/7.” Would you recommend spelling it out?

A: You are right. We don’t address this. But Webster’s 11th does. Both “24-7” and “24/7” are offered as equal variants. I think the latter is more common and would prefer that, without spelling it out.

Q: I understand that human genes are set all caps and italic, with the protein products set all caps and roman. But what to do with proto-oncogenes? Do the examples in section 15.6.2 indicate that, if the c- prefix is used, the lowercase (retroviral) form of the 3-letter oncogene is always used, regardless of whether we’re dealing with humans or mice? I am often presented with c-KIT, c-Kit, and c-kit in one document and would appreciate a clear explanation.

A: For oncogenes, it would always be c-kit and then, based on page 633 of the style manual, KIT for the human gene homologue and Kit for the mouse gene homologue.

Q: To follow your reference style, if “et al” is used, is a period used after “al”? And should the reference number be set as a superscript?

A: To answer your second question first, yes, the reference number should be set as a superscript if you follow the style set forth in the AMA Manual. And unless “et al” ends the sentence, “al” would not be followed by a period (even though it is an abbreviation).—Cheryl Iverson, MA