Search all of the Society for Participatory Medicine website:Search
The Journal for Participatory Medicine's website has moved. Please check out the new website for the latest articles.

JoPM Style Guide


The Journal of Participatory Medicine follows AMA style (American Medical Association Manual of Style, 9th Edition), with some exceptions as originally developed by Medscape. Some of the points discussed below are a reiteration of AMA style but are presented here for easy reference. Please follow AMA style in regard to topics not covered here.


Acronyms and Abbreviations

An article should not be littered with acronyms and abbreviations; they can be confusing for an international audience and may make for a clumsy read. Exercise good judgment when deciding whether to use acronyms and abbreviations. If a lengthy term is used throughout an article, it may make sense to use an abbreviation. If, however, the term is used only once or twice, do not abbreviate, especially if the last occurrence of the abbreviation appeared many pages previously. The goal is to create a good reader experience.

A study/trial name or institution may be more easily recognized by its acronym or abbreviation. In this case, expand the term initially and provide acronym afterwards, even if used only once. Examples:

  • The US Food and Drug Administration (FDA)
  • The National Health and Nutrition Examination Survey (NHANES)
    • Exception: Some study names are derived from foreign words or may be too clumsy or obscure to verify and spell out. In such cases, providing only acronym/abbreviation is permitted.

Do not expand well-known terms (eg, “HIV,” “AIDS,” “DNA”). This may vary by specialty and content type (eg, formal vs informal tone) and should be given careful consideration.

Do not use periods in abbreviations (eg, “US,” not “U.S.”; “MD,” not “M.D.”).

Abbreviate “versus” to “vs” (no period).

In text, avoid clinical Latin abbreviations such as “bid,” “tid,” “q4h.” Instead, spell out the terms in English (eg, “twice daily,” “3 times daily).” In a table, however, you may use abbreviations due to space limitations (include a key beneath table if doing so), or you may prefer to make the dosing schedule a footnote (eg, “*All doses were administered on a twice-daily basis unless otherwise noted”) to avoid clutter.

In titles and headings: Lengthy or unwieldy terms in titles and headings may be more reader-friendly when presented as acronyms or abbreviations. The specialty audience should be considered in such cases.


  • HIV Treatment in the Age of HAART (as opposed to: HIV Treatment in the Age of Highly Active Antiretroviral Therapy)
  • Sodium Intake and Mortality in NHANES (as opposed to: Sodium Intake and Mortality in the National Health and Nutrition Examination Study)

If a term is abbreviated in a title or heading, it should be expanded at first mention in text with abbreviation following. Example:

When highly active antiretroviral therapy (HAART) emerged on the treatment scene…



Medical specialties should not be capitalized in text.

Prepositions and articles. In a title, subtitle, or heading, capitalize if four or more letters. Do not capitalize “vs” in a title.

Hyphenated compounds. See examples below:

  • Six-Year-Old Male Patient
  • Disease-Associated Depression
  • Low-Level Radiation


  • Long-term Use of Ibuprofen
  • Intra-abdominal Surgery

In other words, if the hyphenated compound acts as one word — meaning that each term in the compound relies on the other in order to act as one word — then don’t capitalize the second term in the compound.

Verbs. In a title, subtitle, or heading, capitalize all verbs, even if they are only two letters long (eg, “Is”).



No comma before “Jr” in references, but use comma in text:

* In text: Jerry Jasper, Jr.
* In references: Jasper J Jr (note that there is no period in references)

No comma before roman numeral after a name (Walter Wallingford III).

Do not use a comma in numbers lower than 10,000 (eg, 8090). For numbers higher than 9999, use a comma instead of a space (eg, 11,800 instead of 11 800).

Use a serial comma (before the conjunction that precedes the last term in a series). Example:

  • Genetic, environmental, and behavioral factors should be determined.


Dates, Times, and Calendar Terms


Month and year. Do not use a comma (eg, “the September 2010 of Wired.”). When specifying a date, spell out the name of the month and use the US sequence of month-day-year (eg, “April 1, 2000”).

Decades. Write “in the 1990s,” not “in the 1990’s” (it’s a plural, not a possessive).

Time of day

When expressing a time, use “am” and “pm” with no punctuation (as noted in the Abbreviations section) and don’t use “:00” for the top of the hour (eg, “3 pm;” “11:48 am”).

Calendar Terms

Capitalize the names of days of the week and months, and always spell them out.

Do not capitalize the names of seasons. (Exception: Capitalize seasons when used as the name of a time period, eg, “Fall 2010.”)


Decimals and Leading Zero

Use a leading zero before the decimal for percentages and drug doses, but not for P values. So:

  • 0.57%
  • 0.25 mg
  • 0.71 ng/dL
  • P < .01


Diacritics (Accent Marks)

Retain diacritics in proper names (Cathedral of Nôtre Dame in Paris; Behçet syndrome) in text.

Retain diacritics in foreign words in current usage (résumé, mañana), but do not insert an umlaut over the "i" in "naive."

Retain diacritics in quotations ("Le jour de gloire est arrivé!").


Disease Names

Do not capitalize the word "syndrome" or "disease" in a syndrome/disease entity (eg, Alzheimer’s disease, not Alzheimer’s Disease).

The AMA does not use an "s" in disease names (eg, Sjögren syndrome). House style prefers the "s" (eg, Sjögren’s syndrome).

Do not capitalize a disease name if it is being used in a form other than a proper noun. For example, "Parkinson’s disease," but "parkinsonism" and "parkinsonian features."


Drug and Product Names

JoPM does not include the salt/ester moieties in drug names. If, however, the moiety is crucial to the understanding of the drug’s mechanism of action, or if confusion with another drug would arise if the salt/ester were not included, please add it. Query the clinical editor if you make this addition.

JoPM refers to drugs primarily by generic name. If a drug is well known by its brand name (eg, Viagra®), display both names on first mention and use generic thereafter. Defer to the Scientific Director’s or CME reviewer’s preference. Example:

Patients in the study received 50 mg of sildenafil (Viagra®) 1 hour before anticipated sexual activity. (Sildenafil may be taken anywhere from 4 hours to 30 minutes before sexual activity, but peak plasma concentrations usually are achieved within 1 hour when taken on an empty stomach.)

Brand names may be used throughout an article in the case of pharmaceutical controversy, drug recall, or a matter regarding a specific preparation (eg, Bayer® vs Bufferin®).

Note that previous house style rules prohibited the use of the ® and TM symbols due to coding/browser issues. These are now allowed and should be used.

Exception: Do not use in newsletters/mailed content. Instead, italicize proprietary drug name (eg, Prilosec).

Copyright and trademark symbols:Please verify use of ®, ©, TM by visiting official publisher/manufacturer website. Symbols should be used accurately, not arbitrarily.

If given a list of product names, whether in text or in a table, display alphabetically.


Ending Punctuation

Place a period after the following:

  • Figure captions
  • Source citations/permission statements (for tables and figures)
  • Level 3 and Level 4 headings
  • Reference citations

Do not place a period after the following:

  • Table titles
  • Table abbreviations, legends, notes (exception: multiple sentences)
  • Learning objectives
  • Post-test or other interactive question answer choices (exception: multiple sentences)
  • Level 1 and Level 2 headings
  • Lists of lab values
  • URLs

For punctuation in display/bulleted lists, see Lists section.


Figures and Tables

Use arabic instead of roman numerals for table and figure numbering.

Table titles: Initial caps (title case), all boldface, no ending punctuation. Example:

Table 1. Differential Diagnosis of Delirium and Dementia

When a number begins a table title, spell out (eg, "Four-Month Results of


Figure captions: Only first word and proper nouns capitalized; boldface on "Figure" and number of figure. End punctuation on all captions. Example:

Figure 1. Erythematous lesion in patient with dermatomyositis.

Spell out "Figure" when calling out in text. Do not bold. Example:

The patient presented with an erythematous lesion (Figure 1).

Headings in figures that are similar to or the same as figure captions should be removed to avoid redundancy.

When there is only one table or one figure in an article, refer to it as "Table" or "Figure" and not as "Table 1" or "Figure 1." In the case of a single figure with multiple components, present as "Figure (a), (b)." In the case of multiple figures with multiple components, present as "Figure 1a, 1b."

Table, table title, and any keys or credit lines should appear together (ie, as a unit), with no intervening line space. Example:

Table 2. Prevalence of HPV and ASIL in Relation to CD4 Count Response to Antiretroviral Therapy

Response to Therapy

Prevalence of HPV

Prevalence of ASIL

CD4 count increase of ≥ 100 cells/µL



CD4 count increase of < 100




ASIL = anal squamous intraepithelial lesions; HPV = human papillomavirus

In table legends, the order of appearance is:

  • Abbreviations used in table: italicized, in alphabetical order, no ending punctuation
  • Footnotes: bracketed letters (eg, [a]); no ending punctuation unless full sentence
  • Source citation format: see Permission, Source Citations, Photo Credits

Abbreviations in a table should be expanded in the table legend, even if they have already appeared in previous tables in the same document.

Units of time in tables and figures: sec, min, hr, day, wk, mo, yr

Formatting: Be sure to create separate cells within tables. In other words:

Wrong way:

Number of Patients

Percentage Experiencing Adverse








Right way:

Number of Patients

Percentage Experiencing Adverse









Formatting Reminders

Do not use AutoFormat for line spacing. Be sure to manually insert double spacing between paragraphs.

Do not add a double space after each sentence; use single spaces instead. (Double spaces were helpful in the typewriter age because they provided a visual break between sentences, but in wordprocessing they leave too much blank space between sentences.)

Do not use AutoFormat for lists in the text or for reference lists.

All text, unless a callout, block quote, list, or in a table, should be left-aligned.

No smart (curly) quotes. Use straight quotes only, be they apostrophes or quotation marks.

No em- or en-dashes. Use two hyphens (–) for an em-dash and – for an en-dash. The “–” should have a space before and after.


Gender Neutrality

Avoid the awkward “s/he” and “his/her” by using plurals
whenever possible. However, do NOT use “they” as a singular pronoun. Be sensitive to gender-specific terms and titles. For “policeman,” “waitress,” “chairman*,” “stewardess,” “foreman,” “mankind,” substitute police officer, server, chair, flight attendant, supervisor, humanity. Avoid superfluous gender references
(instead of “male nurse,” say nurse). Also see The Handbook of Nonsexist Writing by Casey Miller and Kate Swift.


Heading Levels

Article sections and subsections should be outlined in this manner. Note capitalization, text effects and placement, and ending punctuation.

The Animal Kingdom

Text text text text text text text text text text

Felines and Felids

Text text text text text text text text text text

Domestic cats.
Text text text text text text text text text text

Tuxedo cats. Text text text text text text text text text text



House style hyphenates: “Co-Editor,” “long-term care”

Don’t hyphenate: “followup” when used as a noun or “follow up” when used as a verb phrase.

Do not place a hyphen after prefixes; make one word (“antiarrhythmic,” “nonresponder,” “preexisting,” “perimenopause,” “posttraumatic,” “intraobserver”). However, if word is hard to read without hyphen (“intraabdominal”[clumsy] vs “intra-abdominal” [better]) or could be misread, do use hyphen. This is a judgment call but be sure to use consistently throughout an article.

Hyphenate an adjective-noun compound when it precedes and modifies another noun (eg, “full-text articles” vs “articles are available in full text”).

Hyphenate adjectival drug-dose phrases (eg, “a 50-mg dose”).

Do not hyphenate names of disease entities used as modifiers (eg, “sickle cell anemia”).

“T cells,” “B cells”—but “T-cell activity” (the “T” acts as an adjective, modifying “cell”).


“-ic” and “-ical”

Historic: important or influential in history (a historic discovery)

Historical: concerned with the events in history (a historical novel)

In general, the “-al” may be omitted from a word unless its absence changes the meaning of the word. The following are examples of case-dependent “-ic” and “-ical” words:

biologic (noun), biological (adjective); classic, classical; economic, economical; empiric, empirical; historic, historical (see above); pathologic, pathological; periodic, periodical; physiologic, physiological


Internet Terms

  • "online," not "on-line"
  • "email," not "e-mail"
  • "homepage," not "home page"
  • "Internet," not "internet"
  • "the Web"
  • "website"
  • "webcast"
  • "web conference"
  • "video blog"
  • "blog," not "Weblog" or "Web log"


In-Text Citations

When citing authors in text, do not use “et al.” Use “and colleagues,” “and coworkers,” or “and associates.”

Use the word “author” to refer to the author of the present article; use the term “investigators,” “researchers,” or “study authors” when referring to authors of cited studies. In less formal or first-person articles, such as an Ask the Experts column, use of “I” instead of “this author” is appropriate.

In-text citations should be surrounded by brackets, with no space before the opening bracket (eg, “Smith and colleagues[5] surveyed 13 stroke patients…”). Brackets come after periods and commas (“According to the results of the STOP trial,[54]” and “The literature supports Dr. Thompson’s findings.[7][8][9][10]”) and before colons and semicolons (“The following drugs were taken off the market in 1996[27]:”)

Note that consecutive reference citations are listed separately rather than as a range.



Genus and species nomenclature: For first occurrence of an organism’s taxonomic designation, spell out full genus and species name and place in italics, capitalizing genus but placing species in lowercase (Streptococcus pneumoniae). For each subsequent occurrence, use first initial of genus followed by full species name, without an intervening period (S pneumoniae).

When genus is used in the plural or adjectivally, do not capitalize or italicize (“streptococcal pneumonia”).

Italicize titles of journals*, books, movies, television shows, plays, paintings, epic poems, musical compositions, genes, some enzymes (see AMA Manual of Style), chemical prefixes, and some mathematical expressions (eg, x, y; See AMA Manual of Style).

*Do not italicize journal abbreviations in reference lists. Journal (and other publication) names should be italicized everywhere else.

Foreign words should appear in italics. Latin words that have come into common usage (such as “per se,” “in vivo,” “in vitro”) do not need to be italicized.



Strive for aesthetics and consistency when using lists in an article; articles that contain numerous lists in both display and numbered format look messy and inconsistent.

Display Lists

Each item in the list should be followed by a semicolon, and a period should follow the last item. Example:

Patients entered into the study:

  • Were older than 65 years of age
    • Were older than 65 years of age;
    • Had a history of myocardial infarction; and
    • Had previously diagnosed diabetes.

    Display lists that contain bulleted lists within require ending punctuation only. Example:

    Patients entered into the study:

    • Were older than 65 years of age
      • o Men (n = 51); women (n = 52)
    • Had a history of myocardial infarction
      • o Within 10 years (n = 60); within 5 years (n = 43)
    • Had previously diagnosed diabetes
      • o Within 10 years (n = 50); within 5 years (n = 53).

    Numbered Lists

    When listing several numbered items, use arabic numerals surrounded by parentheses, but retain in paragraph form rather than creating a list. If there are more than 5 items, arrange them in a display list, with a period after the numeral instead of parentheses surrounding it. Example:

    Risk factors include (1) obesity, (2) smoking, (3) family history of heart disease, and (4) total cholesterol level >240 mg/dL.


    The practitioner should consider the following questions in the context of his or her own practice experience:

    1. Do you measure weight of all patients at every visit?

    2. Do you document BMI on your patients?

    3. How many of your own patients are obese? Overweight?

    4. How much of your clinical practice (ie, how much disease that you see) is caused, or contributed to, by obesity?

    5. Do you make an effort to counsel patients regarding obesity?

    6. Do you make an effort to counsel patients regarding exercise?

    Do not use AutoFormat numbering in numbered lists, including reference lists.

    Lab values should be listed in plain text and left-aligned, with no ending punctuation. Lab test abbreviations in lists, unless obscure, do not need to be expanded. Lab test abbreviations should be spelled out at first mention in text (not list), if applicable. Examples:

    • Sodium: 130 mEq/L
    • Potassium: 3.2 mEq/L
    • Chloride: 102 mEq/L
    • Bicarbonate: 10 mEq/L
    • BUN: 13


    Numbers and Measurements


    Use a numeral or spell it out? In article titles and headings, use numerals (eg, “Randomized Trial of 3-Day Antimicrobial Regimen for Treatment of Acute Cystitis”). Spell out numbers (and their associated units of measure) that appear at the beginning of a sentence, heading, or title or that follow a colon (eg, “Twenty-Milligram Prilosec Approved by FDA”).

    In table titles, use numerals. When a number begins a table title, spell out.

    In text, spell out numbers less than 10, unless they are units of time, weight, or money (Eg, “Four patients and four nurses” but “4 days, 4 kg, $4”).

    Units of time: Spell out “seconds,” “minutes,” “hours,” “days,” “weeks,” “months,” “years” in text. In virgule construction, however, use the abbreviations sec, min, hr, day, wk, mo, yr. Abbreviations are acceptable throughout tables and figures (use sec, min, hr, day, wk, mo, yr). Examples:

    * The patient has been smoking for 25 years.
    * Normal resting heart rate is 70 beats/min.

    Don’t use periods in specific times: 8:30am.

    For decades: Use figures, eg, “the 1980s.” When the century is omitted, the decade is spelled out, lower-case: the eighties. If this becomes awkward, however, use the number preceded by an apostrophe: ’80s.

    For ordinal numbers, spell out first through ninth, but use numerals for anything higher. If a published title or quotation (including material from a conference) uses a number (4th Annual Scientific Meeting of the American Lung Association), retain the number; do not spell out. Note that ordinal numbers pertaining to book editions in reference lists are not spelled out (eg, Manual for the Wechsler Intelligence Scale for Children. 3rd ed.).

    In numbers lower than 10,000, do not use a comma (ie, 8090).

    Use arabic numerals for “phase” and “grade” but roman numerals for “stage”:

    * “phase 2,” not “phase II”
    * “grade 3,” not “grade III”
    * “stage IV,” not “stage 4”


    Common fractions should be written out. Do not use a hyphen unless the fraction acts as an adjective or modifier. Example:

    * “Of the patients who received questionnaires, one third responded.”

    But: “A three-fifths majority was required to pass the law.”
    * “In total, 7/16 of the patients reported symptoms.”


    Abbreviate all units of measure unless no number has been specified with the unit (eg, “A few milligrams is all that is needed.”).

    Spacing: Place a space between numeral and unit of measurement: 3 cm, 4 mm Hg, 22 µg



    Use periods after “Dr,” after middle initials, and after “Jr” (but no period after “Jr” in references).

    Do not use periods after “vs,” “et al,” “eg,” “ie”

    No period between genus abbreviation and species (H pylori).

    Do not use periods in degree titles or other letter abbreviations (ie, MD, not M.D.; PhD, not Ph.D.; US, not U.S.).

    Use only 1 space after a period ending a sentence. Double spaces should be changed to single spaces before a document is sent to Production.


    Permission, Source Citations, Photo Credits

    Source Citation Format

    For Figures: place at bottom of figure caption

    For Tables: place at bottom of table; do not add numbered citation after table title

    Author original and author’s own data


    Author original but data within are from outside source

    Data cited in reference list:

    Data from Brown K, et al.[34]

    Data not cited in reference list:

    Data from Brown K, et al. Arthritis Res Ther. 2008;4:296-308.

    Borrowed; permission not yet received*

    Data cited in reference list:

    From Brown K, et al. Arthritis Res Ther. 2008;4:296-308.[34]

    Data not cited in reference list:

    From Brown K, et al. Arthritis Res Ther. 2008;4:296-308.

    Borrowed; permission received; publisher supplied credit line

    Data cited in reference list:

    From Brown K, et al. Arthritis Res Ther. 2008;4:296-308.[34] (Note: Insert publisher’s permission language; may delete above info if redundant)

    Data not cited in reference list:

    From Brown K, et al. Arthritis Res Ther. 2008;4:296-308. (Note: Insert publisher’s permission language; may delete above info if redundant)

    Borrowed; permission received; publisher did not supply credit line

    Data cited in reference list:

    From Brown K, et al. Arthritis Res Ther. 2008;4:296-308.[34] Republished with permission.

    Data not cited in reference list:

    From Brown K, et al. Arthritis Res Ther. 2008;4:296-308. Republished with permission.

    *We do not publish the language “permission pending” in any of our tables and figures. If permission has not been obtained by the time a project is ready for Production, we include a source citation. Once permission is received, we update the source citation with a credit line via the ProdFix process.

    Photo Credits

    When an author has lent an image to be used, format the figure caption in this manner:

    Figure 3. Dermal fillers: before use.
    Image courtesy of Janice Holmes, MD


    Personal Titles

    Use initial caps in personal titles (eg, Associate Director of Pediatrics, Assistant Professor); this applies to author affiliation fields as well as in text.


    P Values

    For all P values, do not place a zero before the decimal point. P should always be capitalized and italicized, with a space before and after the symbol (<, >, =) that follows it.

    In general, P values should be expressed to two digits to the right of the decimal point, unless P < .01, in which case the P value should be expressed to 3 digits to the right of the decimal. However, if rounding from 3 digits to 2 digits would result in P appearing nonsignificant (such as P = .047), the author may prefer to retain all 3 digits.

    The smallest P value that should be expressed is P < .001, because additional zeroes do not convey useful information.  

    Quotation Marks

    Do not use smart quotes (curly quotes). Use straight quotes instead. Smart quotes have the tendency to turn into nonsense characters when placed in databases. The same is true for apostrophes. Use a straight apostrophe. You can set Word to display quotes and apostrophes as straight instead of curly by selecting AutoCorrect on the Tools menu, clicking on the AutoFormat As You Type tab, and clicking off the “Replace ‘straight quotes’ with ‘smart quotes'” option.

    Single quotation marks are used for quotations within quotations. If you are emphasizing a word with quotes, use double quotes. Examples:

    * The patient told me that she had been diagnosed previously with “enema.” I think she meant “edema.”
    * Dr. Amos replied, “You call your symptom ‘itching,’ but the clinical name for it is pruritus.”

    Quotation Marks and Punctuation

    Punctuation marks that go inside of a quotation mark are periods and commas.

    Punctuation marks that go outside of a quotation mark are colons and semi-colons.

    Question marks, dashes, and exclamation points go inside of a quotation mark only when part of the quoted material. Examples:

    * “By jove!” he said.
    * Some new words and terms added to the dictionary in 2009: “acai”; “carbon footprint”; “memory foam”; and “staycation.”
    * Some call this new drug “revolutionary,” but the experts know the truth.
    * The student asked, “Do we really have homework over the holiday weekend?”
    * He accidentally called his boss “Mom”!


    Race/Ethnicity and Patient-Sensitive Language

    House style prefers “black” to “African American.” Should an author feel strongly that “African American” be used, however, the editors will defer to the author. Also, use “white” instead of “Caucasian,” unless specifically referring to people of the Caucasus region.

    Note that there is no hyphen before “American,” even when used adjectivally (eg, African American patient; Chinese American population).

    Refer to a patient as a woman, man, girl, boy, child, persons, patients rather than “a male,” “a female,” or “subjects.”

    Avoid labeling people with their diseases. Refer to them as “people with diabetes” or “diabetic patients” instead of “diabetics.”

    Avoid assigning blame to patients for their conditions or treatment failures. For example, instead of “The patient failed the therapy,” use “This therapy failed in the patient” or “The patient failed to respond to this therapy.”

    Patients are randomly assigned to studies, not randomized. The study is randomized (in design).



    Use the hyphen in all numerical ranges except where it would cause confusion and in the context of “between” or “from.” Examples:

    * A starting dose of 40-50 mg is appropriate for most adult patients.
    * Of those responding to the survey, 50%-70% said that the new product was good to excellent.
    * A recovery time of 4-6 weeks is expected.
    * The odds ratio was 2.9 (95% CI, 2.2-4.8).


    * The largest group represented was 25- to 49-year-olds.
    * A 4- to 6-week recovery is expected.
    * The prevalence of advanced disease in the population was 1.7% (95% CI, -0.8% to 2.2%).
    * Life expectancy can be anywhere from 5 to 20 years.
    * Experts assert that treatment effects are usually seen between 3 and 5 weeks.



    Do not use AutoFormat when numbering reference lists. Do not use EndNote or other reference-managing programs. JoPM’s publishing platform does not support these programs; their use entails extensive reformatting, which may introduce errors during the production process.

    Per the AMA, appropriate material for citation includes but is not limited to (1) articles published or accepted for publication in scholarly or mass circulation print or electronic journals, magazines, or newspapers, (2) books that have been published or accepted for publication, (3) papers presented at professional meetings, (4) abstracts, (5) theses, (6) CD-ROMs, films, videotapes, (7) package inserts or a manufacturer’s documentation, (8) monographs, (9) official reports, (10) databases, (11) legal cases, and (12) patents. Supply URLs with references whenever possible.

    Don’t include:
    A reference list should not include material submitted (but not accepted) for publication. Such material should be noted within the text as [unpublished data].
    A reference list should not include personal communications; these should be referred to within the text — eg, “In a conversation with A.B. Smith, MD (March 2003)….” Or “According to a letter from A.B. Smith, MD (March 2003)….” Or “According to the manufacturer (A.B. Smith, PhD, oral communication, March 2003), the drug was approved in the US in March 2003.”.

    “In Press”
    Studies that are “in press” may appear in the reference list, but author/editor should attempt to supply an updated reference prior to article publication. Articles accepted for publication or in press should appear in the following manner:

    Journal Article:

    Klassen TP, Watters LK, Sutcliffe BI. The efficacy of nebulized budesonide in dexamethasone-treated outpatients with croup. Pediatrics. In press.


    Morano KR, Lalique S. Lyme disease. In: Mandell G, ed. Principles and Practice of Infectious Disease. New York: Churchill Livingstone. In press.

    Reference Style

    Journal article:

    Shapiro ED, Seltzer EG. Lyme disease in children. Semin Neurol. 1997;17:39-44.
    (Note that journal abbreviation is not italicized. This is house style.)

    (If more than 6 authors, list the first 3, then “et al”)

    Issue with supplement (the basic format)
    Dworkin RH, Jolnson RW, Breuer J, et al. Recommendations for the management of herpes zoster. Clinic Infect Dis. 2007;44(1)(suppl 1):S5-S10.
    Note: if there is no suppl number, leave it blank, e.g., (1)(suppl):S5-S10.

    Editorials or letters (place the article type in brackets [ ])
    Whitcomb ME. The April issue: required reading [editorial]. Acad Med. 2007;82(4):319-320.

    Involvement of Lymphatics in Lymphangioleiomyomatosis

    Book or manual:

    Weschler D. Manual for the Wechsler Intelligence Scale for Children. 3rd ed. San Antonio, Tex: Silver Spurs Press; 1991.

    Edited book:
    Dukes MNG, Aronson JK, eds. Meyler’s Side Effects of Drugs. 14th ed. Amsterdam, Netherlands: Elsevier; 2000.

    Chapter in a book or manual:
    Abbott EJ. Determining a child’s intelligence. In: Wechsler D, ed. Manual for the Wechsler Intelligence Scale for Children. 3rd ed. San Antonio, Tex: Silver Spurs Press; 1991:33-52.

    Presentation/abstract from a conference:

    Coupey SM. Contraception and the adolescent. Program and abstracts of the American Academy of Pediatrics 1998 Annual Meeting; October 9-13, 1998; New Orleans, Louisiana. Abstract 57. (Note: Editor may prefer to use citation from a journal that has published the conference abstracts.)

    Reference Style for Slide Programs:


    Crandall C, et al. J Womens Health. 2002;11:857. (Note: Inclusive page numbers (eg, 857-861), if provided, may be used as well.)


    Jones F, et al. ASCO 2007. Abstract 123. (Note: If abstract # is not known, we may proceed without it, but preference is to track it down and include.)

    Online Sources:

    The sponsoring organization/website name, URL, and date accessed must be included. If an author and article title are available, they will precede the organization name:

    Bachmann GA, et al. Title if Any. Organization. Available at: Accessed May 24, 2007.

    2007 OPTN SRTR Annual Report: Transplant Data 1997-2006. Organ Procurement and Transplantation Network. United States Department of Health and Human Services. Available at: Accessed July 31, 2008.

    YouTube video

    For videos, provide the author only if you are sure that person created the video. Do not list the person posting the video online as the author. If you are unsure, treat the citation as having no author.

    Has an author:

    Takayma-Ogawa J., Willette J. What is information literacy [Video]. YouTube. Published March 14, 2007. Accessed April 30, 2010.

    Has no author:

    Slingshot fun [Video]. YouTube Published January 29, 2007. Accessed April 30, 2010.

    Newspaper Articles:

    Gianelli DM. AMA launching ethics institute for research, outreach projects. American Medical News. November 4, 1996:1, 75.

    Government Documents:

    Congressional Bill or Resolution:
    Medical Error Reduction Act of 2000, S 2038, 106th Cong, 2nd Sess (2000).

    Court Case:
    Cobbs v Grant (8 Cal. 3d 229) 1972.

    Congressional Hearing (p. 76):
    “Include the full title of the hearing, the subcommittee (if any) and committee names, the number and session of the Congress, the date, and a short description if desired.” (p. 76)

    An Example:
    1. Hearings Before the Consumer Subcommittee of
    the Senate Committee on Commerce, 90th Cong,
    1st Sess (1965) (testimony of William Stewart, MD,
    surgeon general).

    Federal Regulation (pp. 76-77):
    “Federal regulations are published in the Federal Register and then codified in the Code of Federal Regulations.” (p. 76) See the following example of a reference for a federal regulation:

    An Example:
    1. Importation of fruits and vegetables. Fed Regist. 1995;60(51):14202-14209. To be codified at 7 CFR Sec.300.


    Specialty-Specific Style Points

    Diabetes & Endocrinology



    * proton-pump inhibitor
    * HBsAg = hepatitis B surface antigen
    * HBcAg = hepatitis B core antigen
    * HBeAg = hepatitis B e antigen


    These acronyms should be expanded at first mention:

    * CR – complete response (or complete remission; query author/editor if you are not sure which is intended)
    * EGFR – epidermal growth factor receptor
    * GM-CSF – granulocyte-macrophage colony-stimulating factor
    * IFN – interferon
    * Ig – immunoglobulin
    * IHC – immunohistochemistry
    * IL – interleukin
    * MHC – major histocompatibility complex
    * NHL – non-Hodgkin’s lymphoma
    * NSCLC – non-small-cell lung cancer (retain hyphen between “non” and “small”)
    * ORR – overall response rate (or overall remission rate, query author if you are not sure which is intended)
    * OS – overall survival
    * PDGF – platelet-derived growth factor
    * PFS – progression-free survival
    * PR – partial response (or partial remission; query author if you are not sure which is intended)
    * RBC – red blood cell count
    * RT-PCR – reverse-transcriptase polymerase chain reaction
    * TNF – tumor necrosis factor
    * TTP – time to progression
    * VEGF – vascular endothelial growth factor
    * WBC – white blood cell count

    Do not expand the following acronyms:

    * DNA
    * HER2, HER2/neu
    * HLA (“HLA antigen” is okay)
    * RNA
    * TNM

    Follow the author’s lead when deciding whether to use abbreviations for chemotherapy drugs (eg, 5-FU for 5-fluorouracil, CMF for cyclophosphamide/methotrexate/5-fluorouracil), but be consistent throughout the document. Be sure to spell everything out at first usage (unless clinical editor specifically requests that you do not).

    Use “radiation therapy” rather than “radiotherapy.”

    Use “x-ray” rather than “radiograph.”

    Be sure that all chemotherapy drug names used are generic names.

    Retain study/trial acronyms/abbreviations in text (spell them out at first use, if it is practical to do so; see Acronyms and Abbreviations), even if they are used only once. Some readers will recognize the study by its acronym/abbreviation only.

    “grade 3,” not “grade III”

    “stage IV,” not “stage 4”
    Genes, Oncogenes, Proteins, Biomarkers

    Gene names should be capitalized and italicized. Oncogenes, however, should be lowercased and italicized. Verification with clinical editor of oncogene status often will be required.

    Protein names should not be italicized.

    Colorectal cancer biomarkers: Ras, K-Ras, N-Ras; ras refers to the entire family.


    Viral load should be expressed as copies/mL.

    HIV-1 RNA level should be expressed as log10 copies/mL.

    CD4 count (not “CD4 cell count”) should be expressed as cells/µL. Note that many authors use “cells/mm3” but please change to “µL.” The numbers require no conversion.

    These acronyms should be expanded at first mention:

    * ART – antiretroviral therapy (try to avoid using this acronym)
    * DOT – directly observed therapy
    * HAART – highly active antiretroviral therapy
    * NRTI – nucleoside reverse transcriptase inhibitor
    * NNRTI – nonnucleoside reverse transcriptase inhibitor
    * PI – protease inhibitor
    * RTI – reverse transcriptase inhibitor
    * STI – structured treatment interruption

    Do not expand the following:

    * HIV
    * AIDS
    * RNA
    * DNA

    For HIV drug names, avoid using the 3-letter abbreviations (eg, RTV for ritonavir, SQV for saquinavir) unless the article is very heavy on drug names. Strive for consistency (ie, don’t use “saquinavir” and “RTV” in the same article, unless it is somehow unavoidable). Here is a good resource for HIV drug names:

    Infectious Diseases

    “Gram stain” but “gram-negative”

    Psychiatry & Mental Health

    * ADHD = attention-deficit/hyperactivity disorder
    * CBT = cognitive-behavioral therapy


    State Names and Universities

    Spell out state names in text.

    Exception: New York, NY

    For publisher locations in reference lists, use state abbreviations (not postal codes) as listed on page 282 of the AMA Manual of Style, 9th ed.

    Use 2-letter (postal code) state abbreviation for mailing addresses only.

    If the name of a university contains the city and state where it is located, do not specify the city and state again (University of California at Los Angeles; University of Minnesota, Minneapolis). However, if the university contains the name of the city only, specify the city and state name after it (University of Pittsburgh, Pittsburgh, Pennsylvania; University of Toronto, Toronto, Ontario, Canada). Example:

    * University of Maryland, Baltimore


    * University of Maryland Medical Center, Baltimore, Maryland



    Use symbols when expressing a measurable statistic (ie, data). Do not use symbols in a more “conversational” context. A good rule of thumb is to use a symbol when there is a unit of measure following the number. Example:

    * CD4 count > 450 cells/µL


    * Women younger than 45 years of age
    * Treatment duration of 6 months or less was required for study enrollment.

    Symbols may be used in figures and when space is at a premium, such as in slides and tables.

    Previous Medscape style prohibited the use of symbols such as =, =, ±, µ, ®, ©, TM. These are now allowed and should be used.

    If using copyright or trademark symbol: Verify use of ®, ©, TM by visiting official publisher/manufacturer site. Symbols should be used accurately, not arbitrarily.

    Avoid superscripting symbols as they may become difficult to decipher.

    Do not insert symbols for fractions. Instead, spell out (eg, “one half,” “three fourths”).

    Greek Symbols

    Do not use Greek symbols; spell out instead. (eg, interferon gamma; beta-blocker)

    Exception: Delta symbol (?) is allowed in formulas and equations.

    Exception: Use the mu symbol (µ) rather than “micro.”

    Note: “alpha-interferon” but “interferon alfa” and “interferon alfa-2a.”


    Underlining and ALL CAPS

    Avoid underlining. In an online article, it looks like hyperlinked text. Also avoid ALL CAPS, which reads as shouting online and does not look professional. Emphasize text (sparingly) with italics instead.

    Book titles should not be underlined; use italics instead. See the Italics section for more information on published and broadcast media.


    Usage Points and Spelling Preferences

    “adherence” not “compliance”

    “alpha-interferon” but “interferon alfa” and “interferon alfa-2a”

    “based on” vs “on the basis of”: Use “on the basis of” when you mean “according to”; use “based on” when you mean “has a foundation in/has resulted from”

    Example: On the basis of data from randomized controlled trials, cognitive-behavioral therapy is the preferred treatment and is based on changing the emotional and psychological associations with sleeping that interfere with proper sleep.

    “breastfeeding” in all cases (noun, verb, adjective)

    “compared to” vs “compared with”: Use “compared to” only when establishing a similarity between 2 entities (“Shall I compare thee to a summer’s day?”). When establishing a head-to-head comparison (which is the case most of the time in medical literature), use “compare with” or substitute with “vs” or “compared against.”

    “comprised of”: No such thing. It’s either “composed of” or “comprises.”

    “data” is a plural noun (“data are accruing”); “genetics” is singular

    “decision-making” (adjective); “decision maker” and “decision making” (nouns)

    “different from,” not “different than”; something cannot differ than something else—it differs from.

    disk = the material between vertebrae

    disc = the thing that you pop into a CD or DVD player

    Eastern time (“2 PM Eastern time”), as opposed to EST, EDT

    “first-line,” “second-line,” etc.

    “health care,” not “healthcare”

    if/whether/whether or not:

    * Use “whether” (not “if”) in the context of discrete choices:
    o The study sought to determine whether treatment A or treatment B would be most effective.
    * Use “if” for conditional contexts:
    o Call your doctor immediately if you experience shortness of breath.
    * Use “whether or not” intelligently. The “or not” is necessary only when “regardless of” is implied:
    o Let me know whether you still plan on going.
    o Give me a call whether or not you are going.

    impact: Do not use “impact” as a verb (“The study impacted the field of infectious disease tremendously.”). As a verb, “impact” means “to press closely together so as to render immovable.” Do use as a noun (“The study had a tremendous impact on the field of infectious disease.”) or choose the verb “affect.”

    “indices” instead of “indexes”

    “less than” vs “fewer than”: Use “fewer” for things that can be counted (in a more tangible sense); use “less” for things that cannot be counted:

    * 3 items or fewer
    * Less than 5 miles to go

    -ly: Avoid “interestingly,” “firstly,” “secondly,” etc. These are false modifiers. Unless you mean to say that someone accomplished something in an interesting manner, “interestingly” is incorrect. “Of interest” or “of note” conveys the meaning more accurately.

    mucus, n.

    mucous, adj. (eg, mucous membranes)

    n vs N:

    * N = entire population under study
    * n = sample of the population under study
    o Example: All patients enrolled in the study (N = 250) were given a questionnaire, but only 50% (n = 125) returned it.

    -point: Use “endpoint” and “timepoint” as opposed to “end point” and “time point”

    possessives: “Jones’ theories,” not “Jones’s theories”

    quirks in spelling (American vs British): Use American spellings. If not sure, consult Merriam-Webster.

    * “acknowledgment,” not “acknowledgement”
    * “judgment,” not “judgement”

    But: “orthopaedics,” not “orthopedics” (but “pediatrics”)

    * “randomized controlled trial” (but “double-blind, randomized, placebo-controlled trial”)
    * “re-treat” when someone is receiving treatment again; “retreat” when someone is escaping

    risk of developing cancer » use “of” with a verb or gerund

    risk for cancer » use “for” with a noun

    “since” vs “because”: “since” is used for time; “because” is used to indicate a cause-and-effect scenario:

    * Since the advent of total hip arthroplasty…
    * Because this drug is still in the experimental phase…


    “speakers bureau”

    “Suggested Reading,” not “Suggested Readings”

    “The Netherlands,” not “the Netherlands”

    “the percentage of patients,” not “the percent of patients”

    “under way,” not “underway”

    United States/US: Spell out “United States” unless “US” is used adjectivally (“Studies conducted in the United States…”; but: “US studies have been conducted…”). The same rule applies to “United Kingdom” and “UK.”

    “while” vs “although”: “while” should be reserved for time-related contexts (“While the study was under way, 13 patients complained of nausea.”). “Although” should be used when the meaning is “even though/in spite of the fact that.”

    “with regards to” vs “in regard to”/”with regard to”: “with regards” means “with warm feelings,” as in “give my regards to.” If you mean “in relation to,” use “with respect to” or “in regard to”

    Words: abbreviation, capitalization, hyphenation, spelling

    • acetaminophen; not acetominophen
    • airways (not breathing tubes)
    • all right (avoid alright) [re: CMoS 5.202]
    • a.m.
    • bird’s-eye
    • biometric (not bio-metric)
    • borderline (not boarderline)
    • brussels sprouts (not Brussel sprouts or Brussels sprouts)
    • checkup (to describe an examination); not check up or check-up
    • desirable not desireable
    • echinacea; not Echinacea
    • end-stage renal disease
    • followup (noun or adjective); follow up (verb-preposition)
    • human papillomavirus, not human papilloma virus
    • high cholesterol (not high-cholesterol)
    • HDL cholesterol (not HDL-cholesterol) [same for LDL]
    • high tech (n); high-tech (adj)
    • life-threatening
    • light-headedness
    • lipoprotein (a); not lipoprotein A
    • low-fat (not lowfat or low fat) [re: AMA MoS 8.3.1]
    • mucus (n); mucous (adj)
    • nonadherence
    • noncommercial
    • nonprofit
    • overbreathing (or underbreathing) CMoS 7.90
    • overuse (not over use)
    • p.m.
    • postmenopausal (not post-menopausal)
    • postpartum (not post-partum)
    • prediabetes [re: MW]
    • recheck; not re-check [eliminate hyphen except to distinguish meaning, as in re-cover or recover – CmoS 7.90]
    • Reye’s syndrome (not Reyes Syndrome or Reye’s Syndrome)
    • run down (transitive verb) – “she was feeling run down last week…”
    • rundown (noun) – “she gave a quick rundown of the steps necessary….”
    • secondary infection – DO NOT USE TERMINOLOGY (use second or additional to denote this type of infection)
    • secondhand smoke (not second hand or second-hand) [re: MW]
    • side effect (not side-effect)
    • third party (n); third-party (adj)
    • well-being
    • white coat hypertension, not white-coat hypertension