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Clarity of expression in scientific writing

By Grant Maxie

Dr. Francisco (Paco) Uzal, lab director, pathologist, and inveterate volunteer, is one of the leading authors in the Journal of Veterinary Diagnostic Investigation and also serves as JVDI Images Editor. Paco has often seen my editing in action, and asked me to share some of my editing conventions with fellow pathologists in the Davis-Thompson Foundation newsletter, which I’m pleased to do.

Scientific writing, whether used in autopsy or biopsy reports, journal manuscripts, or board-type examinations, should follow the ABCs – be accurate, brief, and clear. The guidelines that I follow for grammar, syntax, spelling, and taxonomy derive from published international standards, such as dictionaries, textbooks, style manuals, taxonomy standards (e.g., the International Committee on Taxonomy of Viruses), as are cited in journal Instructions for authors and elsewhere. Although I may be a thorn in the side of some, I do get the occasional gracious comment: from the author of a recent manuscript “Thank you for the rigorous editing and formatting. Among them were many helpful or instructive notes!”

Here are some of the canned comments that I use most commonly when editing:

  • JVDI uses “autopsy” or “postmortem examination” in preference to “necropsy”. See editorial: Maxie G. Autopsy/necropsy, diagnosis/detection . . . what’s in a word? J Vet Diagn Invest 2016;28:87.
  • present – rather than ‘dogs present with…’ (jargon), use “dogs are presented with …”; “the horse had …”; etc. (Humans present themselves for examination, animals do not.) A lesion can never present itself – lesions occur, are seen as, display as, etc.
  • signs and symptoms – signs (objective) are observed; symptoms (subjective) are reported by humans; we observe only clinical signs in animals (fever, etc., animals cannot relay their ‘symptoms’ to us as humans can – headache, etc.). Given that animals cannot express symptoms, their status may be termed subclinical rather than asymptomatic.
  • Disease agents or their products are detected, identified, or characterized, not diagnosed by laboratory tests (by testing, not by diagnostics). Diseases are diagnosed in animals, by clinicians or pathologists, based on clinical and/or pathology assessment and/or supported by ancillary tests.
  • Agent ≠ infection ≠ disease. Agents can be present as commensals without causing disease. Infection can occur without resulting in overt disease.
  • Pathology = the study of disease. Lesions are the findings.
  • Multifocal is a redundant modifier of lesions that are inherently multi and focal, including foci, nodules, abscesses, petechiae, aggregates, masses. I find that multifocal is likely the most over-used term in the pathologist’s lexicon, used especially egregiously in “multifocal foci”.
  • Report mitotic activity as mitotic count (MC) and not mitotic index (MI). Meuten DJ, et al. Mitotic count and the field of view area: time to standardize. Vet Pathol 2016;23:1–15.
  • Eponymous terms are used in a descriptive or adjectival sense, are not true possessives, and hence do not require an ‘s (Gram stain, Masson trichrome stain, etc.). Note: Gram stain, but gram-positive or gram-negative bacteria (CDC Style Guide). “The transition of eponyms to the nonpossessive form is consistent with a linguistic perspective and with trends in English usage.” AMA Manual of Style, 11th ed.
  • Gross or histologic examinations themselves are not pathologic, i.e., abnormal. Hence, pathologic, histopathologic, and cytopathologic findings or features pass muster, but any of these terms modifying “lesions” are redundant – histologic lesion is appropriate; histopathologic lesion is redundant.
  • Which leads us naturally to -ic versus -ical. The shorter form, -ic, is generally preferred (personal preference, or common usage), e.g., bacteriologic, epidemiologic, etiologic, histologic, morphologic, parasitologic, serologic, virologic, zoologic, but this rule is not absolute, and some adjectives are only used in the -ic form, e.g., genetic, but never genetical, and some are only –ical, chemical but never chemic. Some distinctions are clear – economic refers to the area of financial activities; economical means good value, inexpensive, not wasteful. The AMA Manual of Style states that the most important aspect is to use the terms consistently throughout the article, chapter, or publication, but that “… usually the ‘-al’ may be omitted unless its absence changes the meaning of the word.” I delete most of the -als.
  • Eliminate redundancy in descriptions: large in size, soft in consistency, round in shape, red in color, case number 1. ELISA testtest is redundant; ELISA = enzyme-linked immunosorbent assay; A = assay.
  • Humane euthanasia. Humane is redundant, given that euthanasia means good death, and the obverse would be “inhumane euthanasia”. As per the AVMA Guidelines for the Euthanasia of Animals: “A good death is tantamount to the humane termination of an animal’s life.” 
  • Use the active voice and direct speech, and avoid the use of filler words: it is, it was, there is, there has been, it is important, it is hypothesized that, it was predicted that, there is evidence suggesting that, in order to, there is a significant relationship, the presence of.
  • Stacked modifiers. My preference is to form diagnoses as phrases in English, as we would speak, e.g., severe, acute, fibrinous pneumonia, rather than the cumbersome pneumonia, fibrinous, acute, severe.
  • Hyphenated compound modifiers. Examples: reverse-transcription real-time PCR (RT rtPCR); 96-well ELISA plates; T-cell–rich, large B-cell lymphoma (but when used free-standing, T cells, B cells).
  • parasitosis = the parasite is pathogenic and harms its host = active disease; parasitiasis = the parasite is potentially pathogenic but does not harm its host = the carrier state, and applies to the incubation period. A hookworm infection in which there are too few worms to cause significant damage is a case of parasitiasis; a hookworm infection in which the worms cause clinical damage is a case of parasitosis.; Kassai T, et al. Standardized nomenclature of animal parasitic diseases (SNOAPAD). Vet Parasitol 1988;29:299-326.

These notes may be more than what Paco bargained for (I have many more pages of editing conventions!), but I do hope that they help pathologists, especially those in training, to develop good writing habits and to produce accurate, brief, and clear prose communications.

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