AMA style Grammar, punctuation and

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Transcript AMA style Grammar, punctuation and

In God We Trust

AMA Style Grammar

Modifiers

• •

In The Careful Writer advises the use of no more than 2 polysyllabic noun modifiers per noun for the sake of clarity.

Overuse of noun modifiers

Avoid Preferred elderly over-the-counter drug users

elderly users of over-the counter drugs

depression episode

depressive episode, episode of depression

Subject-Complement Agreement

• • •

Subjects and complements should agree in number. The child can take off his own shoes. We asked trial participants dispensers. to return their pill

Pronouns

Pronouns replace nouns. In this replacement, the antecedent must be clear and the pronoun must agree with the antecedent in number and gender .

Avoid: Better: A questionnaire was given to each medical student and their spouses. [Disagreement of pronoun with referent in number; the referent is each medical student (singular), but the pronoun used is plural (their spouses).] A questionnaire was given to the medical students and their spouses.

or A questionnaire was given to each medical student and his or her spouse.

Which and That

Relative pronouns may be used in subordinate clauses to refer to previous nouns. The word that introduces a restrictive clause , one that is essential to the meaning of the noun it describes. The word which introduces a nonrestrictive clause , one that adds more information but is not essential to the meaning. Clauses that begin with which are preceded by commas.

Examples

• • A study on the impact of depression on US labor costs was published in the 2003 JAMA theme issue on depression , which contains articles on a range of similar topics. [Nonrestrictive; there was only one theme issue on depression in 2003.] The issue of JAMA that contained the article on the impact of depression on US labor costs was the 2003 depression theme issue. [Restrictive; there are thousands of issues of JAMA.]

Pronoun-Verb Agreement • •

each, either, neither, one, no one, everyone, someone, anybody, nobody, somebody

always singular several, few, both, many always plural

Each patient was room after… transferred to the operation

Both groups were considered …

Verbs •

In the active voice , the subject does the acting; in the passive voice , the subject is acted on. In general, authors should use the active voice, except in instances in which the actor is unknown or the interest focuses on what is acted on (as in the following example of passive voice).

Passive: Active: Passive: Active: Data were collected from 5000 patients by physicians.

Physicians collected data from 5000 patients.

The definition of bullying used in the survey was taken from previous studies.

The authors used previous definitions of bullying in the survey.

Tense

• • • • The

present tense

is used to express a general truth , a statement of fact, or something continuingly true . He discovered enzymes—RNA polymerases—that directly copy [not copied] the messages encoded in DNA. For this reason, the present tense is often used to refer to recently published work, indicating that it is still valid. Kilgallen's assay results demonstrate the highest recorded sensitivity and specificity to date.

The Paragraph

A paragraph is a cohesive group of sentences . It presents a thought or several related thoughts. Each paragraph should be long enough to stand alone but short enough to hold the reader’s attention. Sentences within a single paragraph should use parallel structure and consistent tense as much as possible.

Transitions

• Transitions are words that signal a connection among ideas. Transitions build bridges between paragraphs (and between sentences) and help the text flow.

• • • • • •

To show addition

: also, furthermore, in addition, moreover

To show contrast

: however, yet, conversely, nevertheless,

although

To show comparison

: similarly, likewise

To show results

: therefore, thus, as a result, consequently

To show time sequence

: first (second, third, etc), later,

meanwhile, subsequently, while

To summarize

: hence, in summary, finally

Present perfect • •

The present perfect tense illustrates actions completed in the past but connected with the present or those still ongoing. It may be used to refer to a report published in the recent past that continues to have importance. Kaplan and Rose have described this phenomenon.

Simple past

• • • • • The past tense refers to a completed action. In a biomedical article, the past tense is usually used to refer to the

methods and results

being described: of the study We measured each patient's blood pressure. Group 1 had a seropositivity rate of 50%. The past tense is also used to refer to an article published months or years ago. Frequently a date will be used in such a reference. In their 1985 article, Northrup and Miller reported a high rate of mortality among children younger than 5 years.

Incorrect: Correct:

In general, tense must be used consistently

There were no adverse events reported in the control group, but there are 3 in the intervention group.

There were no adverse events reported in the control group, but there were 3 in the intervention group.

Double Negatives

• • •

Two negatives used together in a sentence constitute a double negative. The use of a double negative to express a positive is acceptable, although it may be confusing.

Our results are not inconsistent with the prior hypothesis. Rheumatologic uncommon symptoms in both groups.

were not

Contractions

A contraction consists of 2 words combined by omitting 1 or more letters (eg,

can't, aren't

). An apostrophe shows where the omission has occurred. Contractions are usually avoided in formal writing.

Modifiers

A modifier describes another word or word group. Words, phrases, and clauses may all be modifiers. An adjective modifies a noun or a pronoun. An adverb modifies a verb, an adjective, another adverb, or a clause. Clauses or phrases may serve as adjectives or adverbs.

Misplaced Modifiers

Misplaced modifiers result from failure to make clear what is being modified. Illogical or ambiguous placement of a word or phrase can usually be avoided by placing the modifying word or phrase appropriately close to the word it modifies .

Unclear: Better: Unclear: Better: Dr. Young treated the patients using antidepressants. [Who used the antidepressants? Ambiguity makes 2 meanings possible.]

Dr. Young treated the patients with antidepressants.

or [alternative meaning]: Dr. Young treated the patients who were using antidepressants.

The patient was referred to a specialist with a severe bipolar disorder. [Who had the bipolar disorder?] The patient with severe bipolar disorder was referred to a specialist.

Correlative Conjunctions

Parallelism may rely on accepted cues (

either/or, neither/nor, not only/but also, both/and

). All elements of the parallelism that appear on one side of the coordinating conjunction should match corresponding elements on the other side.

• • • •

Avoid:

Probiotics regulate not only the flora constitutes, but also may avoid cholesterol absorption.

Correct:

Probiotics not only regulate constitutes, but also absorption.

avoid the flora cholesterol

Correct: Also correct: Avoid: Correct: Poor drug efficacy may be caused either by lack of absorption or by increased clearance.

Poor drug efficacy may be caused by either lack of absorption or increased clearance.

Three patients either took their medication incorrectly or not at all.

Three patients took their medication either incorrectly or not at all.

Subject-Verb Agreement

The subject and verb must agree in number; use a singular subject with a singular verb and a plural subject with a plural verb. Unfortunately, this simple rule is often violated, especially in complex sentences.

False Singulars

Frequently treated erroneously in this way are the plurals bacteria, criteria, phenomena, and

memoranda

. The distinction between singular and plural, however, should be retained; when the singular is intended, use

bacterium,

criterion, phenomenon, and memorandum

.

One of Those

• •

In clauses that follow one of those, the plural verb form is always correct. Dr. Cotter is one of those researchers who prefer the library to the laboratory.

Punctuations

Boring it is we scape!

Hyphen •

The following common prefixes are not joined by hyphens except when they precede a proper noun, a capitalized word, or an abbreviation:

ante-, anti-, bi-, co-, contra-, counter-, de-, extra-, infra-, inter-, intra-, micro-, mid-, multi-, non-, over-, pre-, post-, pro-, pseudo-, re-, semi-, sub-, super-, supra-, trans-, tri-, ultra-, un-, under-

.

antimicrobial coauthor codirects coexistence coidentity coworker deidentify interrater midaxillary midbrow multicenter nonnegotiable nonresident

overproduction overrepresented overtreatment posttraumatic repossess transsacral ultramicrotome underrepresented

Apostrophe

• • •

Jones ' bones (1 person named Jones) the Jones es' Jones) bones (2 or more people named If a singular or plural word does not end in s, add 's to form the possessive.

a child's wants women's health men's concerns

everyone's answer

Singular alga appendix condyloma acuminatum cranium fistula formula genus index maxilla orbit rhytid sequela vertebra

Plurals

Preferred Plural

algae appendixes or appendices condylomata accuminata [with 2-word Latin plurals, both parts become plural] Crania Fistulas Formulas genera indices or indexes maxillas orbits rhytids sequelae vertebrae

Microorganisms

Consult the latest edition of Dorland's or Stedman's medical dictionary. For organisms that do not have a common plural, add the word species or organisms to the genus name to indicate a plural use.

Genus Chlamydia Escherichia Mycobacterium Proteus Pseudomonas Salmonella Staphylococcus Streptococcus Plural Noun Form

chlamydiae Escherichia organisms mycobacteria Proteus species pseudomonads salmonellae staphylococci streptococci

Abbreviations

For most all-capital abbreviations, the plural formed by adding “

s ”

. Do not use an apostrophe before the s. is

CIs EEGs ORs HMOs

ICUs RBCs

False Singulars

• •

Some nouns, because they end in a “plural” form, are mistakenly taken to be plurals even though they should be treated as singular and take a singular verb (eg, measles, mumps, mathematics, genetics ). Measles is a deadly underdeveloped countries.

disease in

Capitalization

The first letters of words are capitalized in headings except for a coordinating conjunction, an article, or a preposition of 3 or fewer letters, except when it is the first word in a title or subtitle.

Hyphenated Compounds

In titles, subtitles, table headings, and text headings, do not capitalize the second part of a hyphenated compound in the following instances:

If either part is a hyphenated prefix or suffix

• • •

Examples: Nonsteroidal Anti i nflammatory Drugs Self r eferral to Psychiatrists [compound words with the prefix self- are considered one word] Intra a bdominal Surgery

• • • • • •

However, in the case of a temporary compound, in which each part of the hyphenated term carries equal weight , capitalize both words. Cost B enefit Analysis Low L evel Activity Drug R esistant Bacteria B C ell Lymphoma Obsessive C ompulsive Disorder

Spell out number at the first of sentence

Correct and Preferred Usage •

We not infrequently are compelled to refuse publication to an article which contains valuable facts , but which is weighed down with so many imperfections as to discourage one from closer investigation.

abnormal, normal; negative, positive

• • • •

Incorrect:

The physical examination was normal.

Correct:

Findings from the physical examination were normal.

• • • •

Incorrect:

The throat culture was negative.

Correct:

The throat culture was negative for hemolytic streptococci .

Samples • •

Incorrect:

The electroencephalogram was positive.

• •

Correct:

The electroencephalogram showed abnormalities in the temporal regions.

Samples • • • •

Incorrect:

Serologic tests for Treponema pallidum hemagglutination, which were previously negative, are now positive.

Correct:

Serologic test results for Treponema pallidum hemagglutination, which were previously negative, are now positive.

affect, effect

• •

Affect (a- fekt), as a verb, means to have an influence on . Effect (i- fekt), as a verb, means to bring about or to cause .

Ingesting massive doses of ascorbic acid may affect his recovery [influence the recovery in some way].

Ingesting massive doses of ascorbic acid may effect his recovery [produce the recovery].

among, between

• •

Among

usually pertains to general collective relations and always in a group of more than 2. The patients shared the library books among themselves.

Between

pertains to the relation between 1 entity and 1 or more other entities.

For instance, a treaty may be made between 4 powers, since each is defining a relationship with each of the others, but peace may exist among them.

Although and Though

• •

although, though: Although and though may be considered interchangeable. However, although is preferable as a complete conjunction, because though in this construction is an “abbreviation” and thus may be less appropriate for formal prose.

Although the analysis was done correctly, the fundamental terms of the investigation were too narrow to be interesting.

As, Because, Since

• • • • • • • • • •

as, because , since:

As

, because, and since can all be used when “ for the reason that ” is meant. However, in this construction, as should be avoided when it could be construed to mean

while

.

Ambiguous:

She could not answer her page as she was examining a critically ill patient.

Preferred:

She could not answer her page because she was examining a critically ill patient.

Similarly,

since

should be avoided when it could be construed to mean “ from the time of ” or “from the time that.”

Ambiguous:

She had not been able to answer her page since she was in the clinic.

Preferred:

She had not been able to answer her page because she was in the clinic.

Can, May

• • • can, may: Referring to one meaning of can and may, Bernstein in The Careful Writer stated: “Whatever the interchangeability of these words in spoken or informal English, the writer who is attentive to the proprieties will preserve the traditional distinction: can for ability or power to do something, may for permission to do it.” A second meaning of may refers to likelihood or possibility : Dehydration may have contributed to the early onset of shock.

• • • • •

article, manuscript

Published Non published Typescript

article

, manuscript, paper, typescript: An unpublished study, report, or essay—that is, the document itself—may be referred to as a manuscript, paper, or typescript. When published, it is an article.

The authors thank Frank J. Kobler, PhD, for statistical review of the manuscript .

association, relationship

• •

Association is a connection between two variables in which one does not necessarily cause the other.

Relationship implies cause and effect .

comprise, compose

• • • •

Include (

ندش لماش

) the pituitary gland

comprises

the adenohypophysis and the neurohypophysis make up or be a constituent of The adenohypophysis and the neurohypophysis

compose

the pituitary gland

the pituitary gland is composed of the adenohypophysis and the neurohypophysis • The phrase comprised of is never correct !!

dosage, dose

A dose is the quantity to be administered at one time, or the total quantity administered during a specified period. Dosage implies a regimen.

sample •

Example: The usual initial dosage of furosemide for adult hypertension is 80 mg/d, typically divided into doses of 40 mg twice a day.

fewer, less

Fewer and less are not interchangeable. Use fewer for number (individual persons or things) and less for volume or mass degree or value). (indicating

in order to

In order can often be removed from the phrase in order to without changing its meaning. “ to ” is enough.

malignancy, malignant neoplasm, malignant tumor

When referring to a specific tumor, use malignant neoplasm or malignant tumor rather than malignancy. Malignancy refers to the quality of being malignant.

operation, surgery

Surgery

can mean surgical care, surgical treatment, or surgical therapy (ie, the care provided by a surgeon with the help of nurses and other personnel from the first consultation and examination, through the hospital stay, operation, and postoperative care, until the last follow-up visit is complete). • An

operation

is what occurs between the induction of and the patient's emergence from anesthesia— incision, dissection, excision, and closure.

place on, put on

The phrase “to put [or to place] a patient on a drug” is jargon and should be avoided. Medications are

prescribed given

or patients are medications; therapy or therapeutic agents are started , administered .

By and With •

By refers to a method or a modality.

With refers to an

object

!

Data normal distribution was checked by KS(Kolmogorov- Simonov) test.

Bleeding was controlled with an electrocutor.

Bleeding was controlled by suturing.

Labeling •

“Avoid labeling (and thus equating) people with their disabilities or diseases (e.g., the blind, schizophrenics, epileptics). Instead, put the person first.” Avoid: Diabetic patients Preferred: patients with diabetes

Doctor vs. Physician

"Doctor is a more general term than physician because it includes persons who hold such degrees as PhD, DDS, EdD, DVM, and PharmD. Thus, the term physician should be used when referring specifically to a doctor of medicine or osteopathy, ie, a person with an MD or a DO degree.

Employ, use

AMA says avoid to use "employ" in cases " use " is accepted, and use "employ" just as meaning "hire".

Incorrect; Fisher exact test was employed to …

Correct; Fisher exact test was used to …

A three-year!

Not a three-years

A 20 year old man was admitted

forty 7 year old girls were recruited as ..

Suffer from •

Suffer from is avoided because it has a negative load on patient or client

Regarding •

In regard to or with regard to must be replaced with regarding or about based on AMA style.

Example •

With regard to patients’ characteristics, age was higher in control group … • Regarding patients’ characteristics…

suggestive, suspicious

• • • • • • • •

Incorrect:

The chest film was suspicious for tuberculosis.

Correct:

The chest film was suggestive of tuberculosis.

Also correct:

The chest film showed abnormalities suggestive of tuberculosis.

Also correct:

The chest film showed a suspicious lesion, but its nature was unclear.

use, utilize

Use is almost always preferable to utilize, which has the specific meaning “to find a profitable or practical use for,” suggesting the discovery of a new use for something. However, even where this meaning is intended, use would be acceptable.

Spelling •

Please check the spelling of medical terms, drugs, chemical compounds, cities, companies and etc.

Redundant Words and Phrases

• • • • • • • • • • adequate

enough general

rule interval

of time

brief

in duration

large [small, bulky]

in size

combine

together

lift

up completely major

full [empty] breakthrough near

to

• • • • • • • • • • • •

out

of count [divide]

up

outside

of

covered

over

oval [square, round, lenticular]

in shape

distinguish

the difference

each

individual

person

past

history eliminate

altogether

period

of time , time

period,

point in

time empty

out personal

friend

• • • • • • • • • • • predict

in advance

estimated at

about

raised

up fellow

colleagues reassessed

again

fewer

in number

red

in color

filled

to capacity

rough [smooth]

in texture first

initiated

future

plans

• • • • • • • • • • •

skin

rash

2

halves soft [firm]

in consistency

2

out

of 12 sour [sweet, bitter]

tasting uniformly

consistent

still

continues sum

total

tender

to the touch

younger [older] than 50 years

of age true

fact

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