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Preferred Usage

affect, effect

affect (v), to influence
affect (n), subjective aspect of an emotion (psychological studies)
effect (v), to bring about or initiate
effect (n), result or outcome

Alaska Native, Alaska native

Alaska native: anyone who was born and raised in Alaska, regardless of cultural background.

Alaska Native: a person who has origins in any of the original peoples of the area that is now Alaska and who maintains cultural identification through tribal affiliation or community recognition

American Indians, Native Americans

Both terms are acceptable [source: Indians Are Us? Culture and Genocide in Native North America by Ward Churchill, 1994], although Native Americans is preferred. Usage of either term is at the author's discretion.

among, between

Among always applies to >2 objects.

Between literally applies to only 2 objects but may be used with >2 when each is treated individually, as in "a treaty between 3 powers."

and/or

Avoid. In most cases, either andor oris correct. When a choice cannot be made, use "X, Y, or both."

antibodies to, antibodies against

Although somewhat redundant, use antibodies against.

age designations

Term

Age


neonate or newborn

birth to 1 month of age

infant

1 month to 2 years

child

2–13 years

school-age

5–18 years

teenage

13–19 years

adolescent

13–17 years

adult

>18 years

childbearing age

15–44 years

elderly

(determined by the author)


based on, on the basis of

Based on is often erroneously used to mean on the basis of. Correctly used, it follows forms of the verb to be.

The calculations were based on the following results.

biopsy

The procedure of removing and examining tissue, cells, or fluids from the living body. Observations are made on the biopsy specimen, not on the biopsy itself. Biopsy is a noun; do not use as a verb.

black, African American

Use of either term is acceptable at the author's discretion. However, black is not capitalized. Follow author for most terms regarding race/ethnicity.

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brevity

Use as few words as possible to make a point

Instead of…

Use…


the majority of

most or many

prior to

before

at the present time

now

at the time that

when

in terms of

in,of, for

the truth is

is

the facts are

are

in order to

to

large in size

large

period of time

period

very unique

unique


case, patient

A case is a particular instance of disease, illness, injury, or asymptomatic disease. Distinguish between a case (a situation or set of circumstances) and a patient (a human being). Cases do not show symptoms, experience side effects, recover, or die; patients do. Do not dehumanize persons into cases. ("Case-patient," however, is an acceptable term.)

C. perfringenswas isolated in a case of diarrhea. or …from a patient with diarrhea.
Erythromycin is recommended for treating patients with legionellosis.

Avoid use of case except for cases of disease. Phrases like in this caseor in any case may be changed to in this instance or in any event, unless referring to a case of disease.

compare to, compare with

Use compare to for items that are very different. Use compare with for items that are similar. In scientific writing, compare with is most often used.

The sodium levels of the patients in the control group were compared with those of the patients in the study group.
Shall I compare thee to a summer's day?

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compose, comprise

Compose: to total, form, to go together, to make up (an object); always takes the passive voice.

The district is composed of 3 counties.

Comprise: to include, to contain, to be made up of (always takes the active voice; do not say is comprised of). The whole comprises the parts; the parts do not comprise the whole.

The district comprises 3 counties.

continual, continuous

Continual means to recur at regular and frequent intervals. Continuous means to go on without pause or interruption.

The patient with emphysema coughed continually.
His labored breathing was eased by a continuous flow of oxygen through a nasal cannula.

dehumanizing terms

Describe a person as having a condition, not being the condition.

person with diabetes, not a diabetic
person with arthritis, not an arthritic
person with asthma, not an asthmatic

Note that patient refers to someone receiving treatment for a particular condition. In, for example, a seroprevalence study of persons with HIV infection, person with HIV is preferable to AIDS patient, unless the sample is being evaluated or receiving treatment for the clinical condition of AIDS.

Do not refer to a person as a subject. Use patient or participant.

develop

Diseases develop in patients. Patients do not develop diseases.

developed country, industrialized country

Use industrialized, not developed.

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developing country

Use developing or resource-limited, not undeveloped, not developed, not Third World.

diagnose

To evaluate, identify. Conditions, syndromes, diseases, and pathogens are diagnosed. Patients are not diagnosed.

die of, die from

Patients die of, not from, specific diseases or disorders.

different from, different than

Use different from, not different than.

dosage, dose

Dosage implies a regimen; dose implies a quantity. Dosage is the amount of medicine to be taken by a patient in a given period; dose is the amount taken at one time.

due to, owing to

These terms are not synonymous and can be vague. Whenever appropriate, replace with caused by or because of.

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ecologic, ecological

Follow author preference.

e.g., i.e.

Place a comma after these abbreviations. Abbreviated phrase should be introduced by a semicolon if the clause is independent and by a comma otherwise. Do not use etc. in an e.g. or i.e. clause.

e.g. = for example, such as
i.e. = that is, in other words

Examples may be introduced by e.g. but should not be followed by e.g.

Correct: In evaluating an IQ score, several factors, e.g., socioeconomic level, must be considered.
Incorrect: Socioeconomic level, e.g., is a factor to be considered.

eliminate, eradicate

Disease is eradicated from the entire world, eliminated from a country or region.

-emia

This suffix indicates in the blood and should not be used in the plural.

Parasitemia or levels of parasitemia, not parasitemias

epidemic, endemic

A disease is endemic to an area; the area is not endemic.

endemic malaria, disease-endemic areas

Epidemic, a disease that occurs suddenly and in numbers in excess of what would be expected (because it was introduced from outside)

Endemic, belonging or native to a particular people or country, indigenous.  Use "to" with a place and "in" with a population.

Diseases endemic to the tropics
Infections endemic in European wild rodents

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erythrocytes, red blood cells

Use erythrocytes, when possible.

etc.

Avoid in scientific writing; it is vague and frequently redundant, easily replaced with e.g.

etiology, cause

Etiology is the study or description of causes (agents) of a disease. Do not use etiology as a synonym for a cause. Etiology encompasses all the possible causes of a disease.

expire, die

Patients do not expire or have fatal outcomes; they die.  Medications expire.

feel, believe

Use feel to express physical sensations; use believe to express personal conviction, accepting something as true.

The patient felt cold.
The author believed that the theory was sound.

fever, temperature

Fever is a rise of body temperature above normal. If a patient has a temperature of 37.8°C, he has a fever of 0.8°C. Also correct: The patient was febrile (37.8°C).

Please use the Times New Roman degree symbol; do not use a superscript lowercase o.

few, less (fewer, less; fewest, least)

Few refers to units or people that can be counted.

Less refers to quantities of mass, bulk, or volume.

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gram

Gram should be capitalized and never hyphenated when used as Gram stain; gram negative and gram positive should be lowercase and only hyphenated when used as a unit modifier.

Gram staining
gram negative
gram-positive bacteria

Greek letters

Greek letters are preferred to words in most circumstances. In some chemical names, however, the approved nonproprietary name uses the word.

tumor necrosis factor α, β-blocker, interferon-γ, betamethasone, beta carotene

Chi square should always be written as χ2. If the symbol begins a sentence, rewriting the sentence may be desirable.

homosexual, bisexual, gay

Any of these terms are acceptable and dependent on the author's discretion.  Sometimes the phrase "men who have sex with men" or MSM is used because some of these men do not label themselves as gay, homosexual, or bisexual.

-ic, -ical

Dispense with most -al endings. For example, use epidemiologic, geographic, serologic, logistic, immunologic, toxicologic, anatomic.

However, check dictionary and consider author's preference, e.g., biological warfare, ecological, psychological.

immunize, vaccinate

Immunize means to confer immunity; vaccinate means to administer vaccine.

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impact

This trendy word is a red flag for editors. Editors tend to avoid it because it is overused and imprecise and to reserve its use for physical collision or global effect. Whenever possible, a more specific word should be used; otherwise, effect (noun) and affect (verb) are good alternatives.

Avoid: Combination therapy with metronidazole impacted colonization rates.
Better: Combination therapy with metronidazole affected colonization rates.
Preferred: Combination therapy with metronidazole decreased colonization rates.

important

This word is vague and should be avoided. In most cases, it can be deleted without affecting meaning or changed to a more specific adjective.

Avoid: These data suggest important abnormalities…
Preferred: These data suggest abnormalities…

in, among

Conditions usually occur in, not among, persons.

The 25 cases of measles were in school-aged children.
infection in patients, not infection among patients

incidence, prevalence

Incidence (a rate) refers to the number of new cases per unit of population per unit of time. Prevalence refers to the number of existing cases per unit of population at a given time (point prevalence) or in a given time (period prevalence). Refer to cases per unit, not incidence or prevalence per unit.

Correct: cases per 100,000 population
Incorrect: incidence (or prevalence) per 100,000 population

includes

This word indicates that a partial list follows. Do not use it if your list is complete.

Correct:The alphabet includes the letters a, b, and c.
Correct:The first 3 letters of the alphabet are a, b, and c.
Incorrect:The first 3 letters of the alphabet include a, b, and c.

individual, person

Person is a noun; individual is an adjective (e.g., an individual student). Avoid using individual as a noun to refer to persons (animals okay).

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influenza season

Truncate second year for influenza season, when the range is no more than 1 year, and when first 2 digits are the same.

2000–01
but
2000–2002 and 1999–2000

Truncation may be used for other periods that do not follow a calendar year; e.g., school years, fiscal years.

inject, inoculate

Inject a fluid; inoculate an animal or person. Liquid cannot be inoculated into an animal or a petri dish; it is injected into or spread on.

We used a 0.5-mL aliquot to inoculate each mouse.
We injected a 0.5-mL aliquot into each mouse.

injection, intravenous drug user(s)

Be aware of the difference between an injection (not injecting) drug user (IDU) and an intravenous drug user (IVDU). The former includes other forms of drug use such as intramuscular injection.

insure, ensure, assure

Insure means to guarantee life or property against risk (e.g., to underwrite; to give, take, or procure insurance). Ensure means to make certain or guarantee. Assure means to make safe, to give confidence to.

in vitro

Do not hyphenate foreign phrases that are printed without a hyphen in other circumstances (e.g., in vitro translation, in situ protein synthesis, in vitro–stimulated growth, in situ–synthesized proteins).

last, past

Although last is not wrong, most recent or past is often more precise. Last can mean final.

Patients were included if they were symptomatic for the last 10 days. (These are only their last 10 days if they died; past is better.)
Patients reported condom use at their last sexual encounter. (May not be their last; most recent is better.)

leukocytes, white blood cells

Use leukocytes, when possible.

male, female

As nouns, these terms can be considered dehumanizing and are best reserved for laboratory animals. They can be used as adjectives (male adolescents, female participants), but as nouns referring to humans, they should be replaced by men and women or boys and girls.

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molecular weight

The relative mass of a substance. It is a pure number and has no units.

Incorrect: The molecular weight of the protein is 30,000 Da.
Correct: The molecular weight of the protein is 30,000.
Correct: The molecular mass of the protein is 30,000 Da.

morbidity, morbidity rate

Morbidity refers to the condition of being diseased, the rate of illness or disease. Do not use morbidity if illness or disease would work; use morbidity only to refer to the rate of illness in a specified population during a specified time (morbidity rate).

mortality, mortality rate

Mortality refers to the number of deaths from a particular condition. Death is preferred over mortality. Mortality rate is the number of deaths in a particular population divided by the size of that population at the same time.

negative, normal

Examinations and most laboratory tests are neither negative nor normal in and of themselves; interpretations of the test results, however, may be negative or within normal limits.

Observations, results, or findings from examinations and tests are within normal limits or abnormal.

Incorrect: Urinalysis was normal.
Correct: Urinalysis results were within normal limits.

Cultures, tests for microorganisms, tests for specific reactions, and reactions to tests may be negative or positive (reactive, for some).

Electroencephalograms, electrocardiograms, isotope scans, and radiographs are pictures and are, therefore, not negative or positive.

offspring

Use children, not offspring, for humans.

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-ology

This suffix means a branch of knowledge, science, or study of something. Terms ending in -ology (e.g., etiology, pathology, serology) should not be used to describe particular items. All "ology" words refer to the study of something.  For example, the methodology of a research study would be a study of the methods used within the study, while the methods would include the study design and other information about how the study was conducted by researchers.

Incorrect: The pathology was located in the upper part of the gastrointestinal tract.
Correct: The pathologic lesion was located in the upper part of the gastrointestinal tract.

Incorrect: The histology was small-cell carcinoma of the lung.
Correct: The histologic diagnosis was small-cell carcinoma of the lung.

Incorrect: The patient's serology showed…
Correct: The patient's serologic test results showed…

Incorrect: We used the following methodology.
Correct: We used the following methods.

parameter

Parameter has a specific statistical meaning and should not be used to mean measurement, value, or number. Ordinarily, except when a descriptive quantity for a statistical population is meant, parameter should be changed to measurement, value, quantity, variable, number, or a comparable term.

patient

An ill person who is receiving or has received medical care. Do not use the term normal patient.

person, persons, people

Person is preferred over individual as a noun. The plural of person is persons, not people. The latter term refers to a group of persons who share particular characteristics (e.g., the American people).

population, sample

Population refers to the set of entities from which statistical inferences are to be drawn. Sample is that portion of the population that is under study.

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present, present with

As a synonym for seeking treatment, present is jargon and should be avoided.

Incorrect: The patient presented with…
Correct: The patient sought treatment for…
Correct: The patient had…

preventative, preventive

Preventative is becoming obsolete; preventive is preferred.

rate, ratio

Rate is the incidence of a disease (or number of deaths) in a specified population in a specific time period. If no time period is specified, ratio is preferred.

The overall case-fatality ratio for SARS is ≈12%
The rate of West Nile virus infection in Canada is ≈300 per 100,000 population per year.

react, test

A substance is tested for a reaction with another substance; it is not reacted with another substance.

resolve

Symptoms are resolved; patients do not resolve their symptoms.

risk of, for, from

What is my risk of getting AIDS?
Men who have sex with other men are at highest risk for AIDS.
The most serious risk from AIDS is death.

To avoid categorization by group, do not use high-risk as an adjective. Similarly, replace high-risk groups with groups at high risk.

Incorrect: high-risk youth
Correct: youth at high risk

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sacrifice

A euphemism for killing laboratory animals after an experiment. Preferred terms are humanely kill or euthanize.

serum, sera

Serum and the names of other body fluids should not be singular if they mean samples collected from different patients. Change serum of patients to serum samples or serum specimens. Be sure to use the word samples or specimens if a specific number is given: 14 serum samples, not 14 sera.

sex partner

Use the term sex partner, not sexual partner; however, the term sexual behavior is correct.

since, because

Using since when you mean because can create ambiguity (causal vs. temporal).

Vague: Since they began treatment, the patients were more active.
More clear (meaning #1): Because they began treatment, the patients were more active.
More clear (meaning #2): After they began treatment, the patients were more active.

significant

Significant has a specific statistical meaning. If that is not the meaning intended, substitute a synonym, e.g., marked, noteworthy, substantial. When using in the statistical sense, the modifier statistically is redundant.

Incorrect: We included all statistically significant variables in the multivariate model.
Correct: We included all significant variables in the multivariate model.

subject

Do not refer to human participants as subjects. Substitute participant, patient, or person.

survival

Be sure to clarify whether survival refers to times or rates.

target

This term is dehumanizing and often misused. Targeting people is like painting a bulls-eye on them. If you must target something, be sure you do not confuse it with aim.

Dehumanizing: Our program targets low-income women.
Better: Our program serves low-income women.
Better: Our program addresses the needs of low-income women.

Incorrect: We targeted the program to low-income women.
Better: We focused the program on low-income women.

Incorrect: We targeted the intervention to rural areas.
Better: The intervention targeted rural areas.

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test positive

 Samples, but not patients, can test positive.

time designations

From March to August (excludes August)
From March through August (includes March and August)
Between March and August (excludes March and August)
1960s, not 1960's
once a day, not daily or qd
twice a day, not twice daily or bid
1986 to 1987 (1-year period). Between 1986 and 1988 is also a 1-year period [1987]).
1986 through 1987 (2-year period)
1986–1987 (2-year period)
AM, PM (small caps)
AD (small caps)
3:00 pm, not 15:00

titer

Use only as a noun, not a verb, and use American spelling.

Incorrect: were titered
Correct: titers of… were determined

Titer reflects dilution, not optical density. For optical density, state the optical level that determines positivity.

Use a colon to express a ratio or dilution. Titers are expressed as the reciprocal of the dilution.

(length:width, 2:1)
The end IgG titer was 256 after a serial 1:2 dilution.

tracking

The use of the word tracking is considered jargon when used in place of proper English.

Incorrect: tracking people
Correct: analyzing trends among persons

treatment

Avoid anti-[disease] treatment.

Preferred: TB treatment
Avoid: anti-TB treatment

using

The word using probably causes more dangling participles than any other word.

            Incorrect: Using inhalation anesthesia, the dogs were splenectomized.
            Correct: Using inhalation anesthesia, we splenectomized the dogs.

Using requires the word by when the actor is not specified.

By needed: Age was determined by using body mass and/or reproductive characters.
By not needed: We calculated age-specific hospitalization incidence rates and fitted linear models, using the χ2 test.

while, although

Although is more precise when you mean in spite of the fact that. While also has a temporal meaning of during the time that.

Vague: While a vaccine is not yet available, many candidate vaccines are being tested. (Either meaning could apply.)
More precise: Although a vaccine is not yet available, many candidate vaccines are being tested. (Has only 1 meaning.)

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Additional Information:

Abbreviations
Capitalization
Dates
Geographic Designations
Punctuation
References
Scientific Nomenclature
Spelling
Grammar
Units of Measurement

Comments to the EID Editors

Please contact the EID Editors at eideditor@cdc.gov

The opinions expressed by authors contributing to this journal do not necessarily reflect the opinions of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.

This page posted January 29, 2009
This page last reviewed August 12, 2009

Journal Contents

General Information

Safer Healthier People

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