Style in Scientific Writing

Arash Etemadi, MD PhDDepartment of Epidemiology and Biostatistics,

Tehran University of Medical Sciences

What is style? • Communication is an attempt to sell someone else our

ideas• Style in writing is all about choice of how this is done• Every writer has available resources of a full language• English has particularly large choice of words and

structures• Style is a choice of these that covers balance, emphasis

and tone• No such thing as a “correct” style• Each writer selects arrangement of words to best

express intended meaning and obtain desired response from readers

Is there a “correct” style?

Example• The door is not to be opened during a session

because the delegates may escape• Do not open the doors during a session; the

delegates may escape• On no account should the doors be opened

during a session, or the delegates may escape• The delegates may escape: do not open the

doors during a session

Good writing

• Good writing is not just about a consistent choice from one side of these oppositions

• The best writing has variety and flexibility• Medical writers use formal, third-person,

passive, impersonal constructions: the “dull dog”

Two important principles

• Clarity• Brevity

Clarity

• Write with a design• Avoid eccentricities of language• Use simple, short sentences• Put message at start of sentence• Maintain unity of thought in sentences and

paragraphs• Keep paragraphs short

Punctuation is powerful

• An English professor wrote the words: "A woman without her man is nothing“on the chalkboard and asked his students to punctuate it correctly..

• All of the males in the class wrote : “A woman, without her man, is nothing.”

• All the females in the class wrote : “A woman: without her, man is nothing.”

Effective Paragraphs• Length

– 100 to 400 words• Development

– Unity– Coherence– Completeness

• Function – Introduction– Transition– Emphasis– Conclusion

You can say a lot in 70 words1974 by Tim Browse, London, UK

The solicitor stood up. "So you won't pay the outstanding council tax?" "No." said the old man, standing calmly in the dock. "Why not? You think you're special?" "No. But I don't see why I should have to pay for my wife, too." The solicitor smiled, and leaned forward. "That's the way it works. Why shouldn't you pay like everyone else?" The old man paused. "Because she died in 1974."

1. Match your content to your readers’ knowledge.

”HOMAهاي پارادايمي اساساً مدلي از گروه مدلهاي هايي )برخالف مدل (. چنين مدل75است )

اند كه هايي با پاية فيزيولوژيك حداقلي( مدلهاي آنها بر اساس نُرم جمعيت تنظيم پاسخ

“شده است.

2. Keep information specific rather than general.

3. Write in plain language. Keep your sentences short.

4. Use tables, diagrams, flowcharts and graphs.

• Keep your sentences short and simple (an average of 20 words, or so)

• Use the active not the passive ("We did" rather than "It was done")

• Be positive rather than negative (He was "usually late" rather than "not often on time")

• Prefer simple words ("about" rather than "approximately," "raised" rather than "elevated")

• Avoid needless words ("absolute perfection" is too much; "perfection" will do).

Some tips for writers

• Write paper first, do research later• Ask an enemy to comment on the paper• Ask a 14 year old to read the paper• Try to win the Nobel prize for science, not for

literature • Learn from journalists• Improve writing skills• Keep it simple

Help!• This was the first sentence of a recent scientific

article in the Journal of Clinical Oncology (Introduction section):

• “Adoptive cell transfer (ACT) immunotherapy is based on the ex vivo selection of tumor-reactive lymphocytes, and their activation and numerical expression before reinfusion to the autologous tumor-bearing host.”

• Aaaccckkkk!!!!! That sentence does not make me want to read on…

“GET TO THE POINT!”“Now if you will all give me your attention…

I’ll try to give you a complete overview… A complex situation such as this one has many subtle layers of meaning… Furthermore we need to examine the juxtaposition of forms… while delving deeper into interpretive understanding of each … but let me digress a moment…beetle bailey Mort Walker

Good writing style

• Spend time acquiring a good, readable style of writing

• Be clear and concise• Avoid using too many long sentences• When you have the choice of two words,

use the simpler one• Avoid using colloquial language (are you

sure you know the culture?)

Do NOT

• Use big words that you do not really mean– Attributable– Causality– Preferential– Significant (without statistical evidence)– Validity

• Mix incidence and prevalence• Mix frequency, rate, proportion, ratio

Writing Good Sentences

• Use the correct tense- present means it is true while past means it is true under a specific set of circumstances

• Do not switch tenses frequently

Report methods in past tense (“we measured”),

But use present tense to describe how data are presented in the paper (“data are summarized as means SD”)

Writing methods:verb tenses

Writing Results: tense

Use past tense, except to talk about how data are presented in the paper.

e.g.:We found that…Women were more likely to…Men smoked more cigarettes than…

BUT:Figure 1 shows…Table 1 displays…The data suggest

The Scientific ManuscriptWriting Results: tense

Example:Information was available for 7766 current cigarette smokers. Of these, 1216 (16%) were classified as hardcore smokers. Table 1 gives characteristics of all the smokers. The most striking difference was that hardcore smokers were about 10 years older on average and tended to be more dependent on tobacco. Significantly more hardcore smokers had manual occupations, lived in rented accommodation, and had completed their full time education by the age of 16 years. There was no difference by sex.

FROM:Jarvis et al. Prevalence of hardcore smoking in England, and associated attitudes and beliefs: cross sectional study BMJ  2003;326:1061 (17 May)

The Discussion: verb tenseVerb Tenses (active!):Past, when referring to study details, results, analyses,

and background research:• We found that • They lost more weight than• Subjects may have experienced• Miller et al. found

Present, when talking about what the data suggest … The greater weight loss suggests The explanation for this difference is not clear. Potential explanations include

• Avoid long strings of adjectives• Avoid long strings of nouns

Overview of principles…

Today’s lessons:Words:• 1. Reduce dead weight words and phrases• 2. Cut, cut, cut; learn to part with your wordsSentences:• 3. Follow: subject + verb + object (SVO) • 4. Use strong verbs and avoid turning verbs into nouns • 5. Eliminate negatives; use positive constructions instead• 6. Use parallel Construction

Principles of Effective Writing

Words• 1. Reduce dead weight words and phrases

• Get rid of jargon and repetition

Principles of Effective Writing

“The expected prevalence of mental retardation, based on the assumption of a normal distribution of intelligence in the population, is stated to be theoretically about 2.5%.”

Examples:

Principles of Effective Writing

“The expected prevalence of mental retardation, based on the assumption of a normal distribution of intelligence in the population, is stated to be theoretically about 2.5%.”

Examples:

Principles of Effective Writing

“The expected prevalence of mental retardation, based on the assumption of a normal distribution of intelligence in the population, is stated to be theoretically about 2.5%.

“The expected prevalence of mental retardation, if

intelligence is normally distributed, is 2.5%.”

Examples:

Principles of Effective Writing

• A majority of most• A number of many• Are of the same opinion agree• At the present moment now• Less frequently occurring rare

Clunky phrase Equivalent

Principles of Effective Writing

• With the possible exception of except• Due to the fact that because• For the purpose of for

Beware of Use instead

Principles of Effective Writing

• 2. Cut, cut, cut; learn to part with your words

Principles of Effective Writing

Example:“Brain injury incidence shows two peak

periods in almost all reports: rates are the highest in young people, and the elderly.”

More punch“Brain injury incidence peaks in the young

and the elderly.”

Principles of Effective Writing

Sentences

• 3. Follow: subject + verb + object(active voice!)

Principles of Effective Writing

“Subject verb object”“Subject verb object”“Subject verb object”“Subject verb object”or just…“Subject verb”

Principles of Effective Writing

The passive voice….• In passive-voice sentences, the subject is acted

upon; the subject doesn’t act.• Passive verb = a form of the verb “to be” +

the past participle of the main verb • The main verb must be a transitive verb (that

is, take an object).

Principles of Effective Writing

"Cigarette ads were designed to appeal especially to children."

vs. "We designed the cigarette ads to appeal especially to

children.”

Responsible party!

Principles of Effective Writing

MYTH: The passive voice is more objective.

It’s not more objective, just more vague.

Principles of Effective Writing

Passive:

To study DNA repair mechanics, this study on hamster cell DNA was carried out.

More objective? No! More confusing!

Active:

To study DNA repair mechanics, we carried out this study on hamster cell DNA.

Principles of Effective Writing

Passive:General dysfunction of the immune system has been suggested at the leukocyte level in both animal and human studies.

More objective? No! More confusing!

Active:Both human and animal studies suggest that diabetics have general immune dysfunction at the leukocyte level.

Principles of Effective Writing

A note about breaking the rules…

Most writing rules are guidelines, not laws, and can be broken when the occasion calls for it.

Principles of Effective Writing

For example, sometimes it is appropriate to use the passive voice.

• When the action of the sentence is more important than who did it (e.g., materials and methods)

Three liters of fluid is filtered through porous glass beads.

• When the subject is unknown“The professor was assaulted in the hallways”– they

do not know the perpetrator of this heinous crime.

Principles of Effective Writing

• 4. Use strong verbs and avoid turning verbs into nouns

Principles of Effective Writing

Obtain estimates of

Has seen an expansion in

Provides a methodologic emphasis

Take an assessment of

Weak verbs

Formerly spunky verbs transformed into boring nouns

estimate

has expanded

emphasizes methodology

assess

Principles of Effective Writing

Provide a review of

Offer confirmation of

Make a decision

Shows a peak

review

confirm

decide

peaks

Principles of Effective Writing

The case of the buried predicate…

One study of 930 adults with multiple sclerosis (MS) receiving care in one of two managed care settings or in a fee-for-service setting found that only two-thirds of those needing to contact a neurologist for an MS-related problem in the prior 6 months had done so (Vickrey et al 1999).

predicate

subject confusing garbage

Principles of Effective Writing

The case of the buried predicate…

One study found that, of 930 adults with multiple sclerosis (MS) who were receiving care in one of two managed care settings or in a fee-for-service setting, only two-thirds of those needing to contact a neurologist for an MS-related problem in the prior six months had done so (Vickrey et al 1999).

Principles of Effective Writing

• 5. Eliminate negatives; use positive constructions instead

Principles of Effective Writing

• He was not often on time– He usually came late.

• She did not think that studying writing was a sensible use of one’s time.– She thought studying writing was a waste of time.

Principles of Effective Writing

6. Use parallel construction

Principles of Effective Writing

Pairs of ideas—two ideas joined by “and”, “or”, or “but”—should be written in parallel form.

Cardiac input decreased by 40% but blood pressure decreased by only 10%.

SVX but SVX

Principles of Effective WritingParallelism

Not Parallel:If you want to be a good doctor, you must study hard, critically think about the medical literature, and you should be a good listener.

Parallel:If you want to be a good doctor you must study hard, listen well, and think critically about the medical literature. (imperative, imperative, imperative)

Parallel:If you want to be a good doctor, you must be a good student, a good listener, and a critical thinker about the medical literature. (noun, noun, noun)

George Orwell's rules1. Never use a metaphor, simile, or other figure

of speech which you are used to seeing in print. 2. Never use a long word where a short one will

do. 3. If it is possible to cut a word out, always cut it

out. 4. Never use the passive where you can use the

active. 5. Never use a foreign phrase, a scientific word,

or a jargon word if you can think of an everyday English equivalent.

6. Break any of these rules sooner than say anything outright barbarous