»‘In that case,‘ said the Dodo solemnly rising to its feet, ‘I move that the meeting adjourn, for the immediate adoption of more energetic remedies…’ ‘Speak English!’ said the Eaglet. ‘I don’t know the meaning of half those long words, and what’s more, I don’t believe you do either!’ And the Eaglet bent down its head to hide a smile: some of the other birds tittered audibly.’« – Alice’s Adventures Through the Looking Glass, Lewis Carroll
Choosing the most appropriate word
In medical writing, it can be tempting to use words which sound more scientific but which may be unfamiliar. Try to resist this temptation! The English language is rich in synonyms, most of which are partial synonyms. Compared with strict synonyms which have exactly the same meaning, partial synonyms have differences, albeit subtle, in meaning. If you use a partial synonym which is less familiar, you take the risk of giving your writing an unwanted shade of meaning, or a completely wrong meaning altogether.
For example: ‘Anthropomorphic data were similar between the two treatment groups.’ Here, the writer has confused the word ‘anthropomorphic’ with ‘anthropometric’. Anthropomorphism means the attribution of a human character/personality to a god, animal or object whereas anthropometric, the word the writer intended to use, means the measurement of the human body (age, weight, sex, etc.)
Other more subtle examples include: ‘Cases whose conditions are not improving should be evaluated’. Here the writer has used the word case instead of patient. However, a patient is a particular person under medical care whereas a case is a particular instance of a disease, so in this situation patient is more appropriate. Another example is: ‘Evaluation should be performed by the patient’s primary care provider’. However, a provider could be a medical institution, a third-party payer, or a health care professional and so it is better to be more specific in this situation, such as ‘primary care physician’ or ‘primary care hospital’.
Simpler is often better
Administer versus give
In general, when writing about administration of drugs, ‘give’ is better than ‘administer’, unless there is something very complicated about the way a drug is given. If a drug is given intravenously or infused, ‘injected’ or ‘infused’ is better than either ‘administered’ or ‘given’ as this word is a more precise description of the procedure.
Ameliorate versus lessen, settle, resolve
‘Ameliorate’, meaning to cause to become better, is a somewhat awkward sounding word and is often better replaced by a more compact word. In this example, ‘Fever often takes longer to be ameliorated in patients with more severe illness’, ‘ameliorated’ could be replaced by ‘lessened’, ‘resolved’, or ‘settled’. All of these words mean to decrease, which is what happens when a fever improves, and therefore they provide an alternative to ‘ameliorated’ which has a more precise, and hence clearer, meaning.
Armamentarium versus range of treatments
‘Armamentarium’ is a commonly used and rather pompous sounding replacement for the words ‘range of drugs’ or ‘range of treatments’. It is also often used incorrectly in combination with the superfluous word ‘drugs’. For example: ‘From cytotoxic therapies to precisely targeted molecules, the armamentarium of treatments for patients with metastatic cancer is continuously growing. In this example, ‘of treatments’ is not needed and should be omitted if ‘armamentarium’ is definitely wanted in this sentence. If ‘armamentarium’ does need to be used, ‘range of treatments’ sounds better.
Words with similar but different meanings
Comparable versus similar
Strictly speaking, any one thing is comparable with any other thing, no matter how great the differences are between the two things being compared. In comparison, ‘similar’ means that the things being compared share similar features, and so this is a more precise and therefore preferred description. However, in medical writing ‘comparable’ is regularly used instead of ‘similar’. For example: ‘Patient characteristics in both treatments arms were comparable, with respect to age and weight.’ In this example, the writer is trying to convey that the patients shared similar characteristics. Therefore, ‘Patient characteristics in both treatment arms were similar, with respect to age and weight’ is preferable and ‘The patients were of similar age and weight’ is even better.
Data versus information, results
‘Data’ is a word best used for measurements or observations made during a study period whereas ‘results’ and ‘outcomes’ are best used for descriptive texts. ‘Findings’ is a word usually used as part of the broader scientific process of observation, reflection and discussion and places the results within the context of the associated scientific field.
Data is a plural noun, with datum being the singular form. ‘Data point’ is commonly used in medical texts but this should in fact be ‘datum point’ and additionally, the use of ‘point’ is superfluous.
Efficacious versus effective
‘Efficacious’ has a precise meaning: the performance of an intervention under ideal and controlled circumstances, usually a clinical trial. In contrast, ‘effectiveness’ refers to the performance of an intervention under real-world conditions and provides for external factors at the patient, provider and system level. Although important, the distinction between these two descriptions is often poorly understood.
Level versus concentration
‘Levels’ of liquid rise and fall and ‘concentrations’ of ions increase or decrease. So therefore, in this example: ‘The sodium level in the patient’s plasma was higher than had been previously observed’, ‘level’ should be replaced by ‘concentration’.
Variation versus variability
‘Variation’ refers to changes over time in one patient (in plasma drug concentration, for example) whereas variability refers to the differences between patients at particular sampling times. Therefore, in this example, ‘The differences were statistically significant due to low variation …’, the correct word is actually ‘variability’.
These are just a few examples of common mistakes made when not choosing the most appropriate wording in medical writing. In conclusion, simplicity is key, with both sentence structure and wording choice. Additionally, always make sure you fully understand the meaning of the word before using it – in the age of Google, this should not be a problem – and remember that although words can have very similar meanings, sometimes there can be subtle yet important differences between them.