AMA Manual of Style: A Guide for Authors and Editors: Special Online Bundle Package [Hardcover]

At long last, the 10th Edition of the AMA Manual of Style is finally available, and I am happy to say it was worth the wait. As an editor who has worked in medical journals, scientific Web sites, and an agency specializing in pharmaceutical advertising, I found the 9th edition to be, at times, a bit dated and not as easy to navigate as I would have hoped. Most of those problems have been resolved in the 10th edition, as well as the inclusion of some new information that I didn't even know I was missing until I found.

The following is a list of changes in the new edition of the style guide that I found particularly helpful and relevant, and will hopefully be a quick go-to guide when you're debating whether to buy the new version or hold fast to the 9th edition.

- The section on Correct and Preferred Usage has moved from Chapter 9 to Chapter 11 and includes a wealth of information that was not in the previous edition. There is more information about the difference between race and ethnicity and when it's relevant to include sexual orientation in a scientific manuscript.

- An extended section on electronic references (3.15, 63-72). This new info is highly relevant considering since 1998 (when the 9th edition was released) there have been a number of innovations with the Internet and a number of authors choose to use the Web as sources of information.

- The section on manuscript preparation is vastly improved and expanded (Ch 4). It includes more information on the different types of tables and figures as well as new guidelines for the use of symbols and footnotes.

- Of particular interest to journal editors, there is more information on authorship requirements, conflicts of interest, sources of funding, and copyright and permissions basics (Ch 5).

- The section on capitalization demonstrates that, not only can the AMA editors laugh at themselves, but that they're also familiar with the lyrics of Coolio (eg, There is no party like a West Coast party because a West Coast party doesn't stop. 10.3, 375). The section on capitalization also includes newer terms like iBook and eBay that are more relevant to modern writing (10.8, 380).

- In terms of grammar, some of the rules that always give editors trouble are more explicitly outlined and in more detail. There's a longer section on the use of that and which (7.2, 318), which I still have to look up occasionally. A final ruling on the health care vs healthcare debate (always 2 words, per AMA, 11.1, 395). And more specific rules on false/parenthetical plurals and sentences with compound subjects (7.8)

- A change in the use of states in references. All will use postal codes now, instead of the former abbreviations (14.5, 451-455).

- An expanded section on international currency (18.5.12, 817-819).

- The section on terminology has been expanded to include information about different specialties, including psychiatry, ophthalmology, and obstetrics (Ch 15). This section also includes a new chart with human viruses that is expanded and easier to navigate (15.14.3, 762-767).

- There is a more comprehensive copyediting section, including information on editing numerical information (21.1, 907; 23.1, 929-933).

- And finally, and most importantly for all newer medical editors and writing, there is a more informative resources guide with professional organizations aimed at scientific writers and editors as well as grammar and editing resources (25, 967-976).

As a whole, I'm very pleased with the new edition of the AMA style guide, and can't wait to incorporate the new changes into my own work.

Style manuals are written either for editors or for authors, rarely for both. The AMA manual is a text only editors could love, it serves the interests of authors mostly as an afterthought. The "Instructions for Authors" on JAMA's website presents the essential requirements of the style in a more concise format for journal articles, the vehicles of research reporting. This is also two texts in one, a text on style and a text on medical terminology and ethics, a dubious combination. Style, by its very nature, is well served by a ten-year publication cycle. It should change only very slowly. Medical terminology, on the other hand, is in a constant state of flux. Authors working in a field are well aware of the accepted nomenclature without the need to be reminded by an inevitably dated style manual. This text is written for editors at some remove from medical practice and research. This review, on the other hand, is from an author's point of view.

The last edition of the AMA manual (1997) sought to impose the metric system on clinical measures. This initiative failed. It was simply ignored in preference to the conventional measures used in clinical practice. The new AMA style requires a conventional measure to be followed by a metric conversion factor. For example, the new AMA manual is a heavy tome, the one-thousand-plus page text weighs 4.2 pounds (to convert to kilograms multiply by 0.45). This is a sensible and useful requirement. However, you need not buy the manual to get the exhaustive conversion table, it's available on the JAMA website.

The new manual also accepts the "versioning" of online documents as research references. In effect, an online clinical or research report can be changed once published, without the change being documented, and still be considered a credible reference. I find this practice wholly unacceptable, and I'm a mere anthropologist, not an MD. Corrections, retractions, revisions, errata, and so forth to print articles are documented in print. The same standard must apply to electronic documents. Those who argue that the practice of medicine is more an art or craft than a science may be right, but it is not a whimsical craft.

The text is a curmudgeon's delight. For example, the table of contents lists a section on "Measurement and Quantitation." Do they mean to say "quantification," not "quantitation?" Alas, my dictionary has no such word. Abbreviations are used for the names of journals when composing references to articles. On at least three instances, the AMA manual refers readers to different sources where the standard abbreviations can be found. None get it right. The standard reference used to be the "Index Medicus" published by the National Library of Medicine. The name has changed to the "List of Journals Index by Medline" and it is available free online.

If you are sufficiently knowledgable to write authoritatively on a subject, then you are familiar with how the research community talks about it, and they have litttle regard for style guides. For example, a highly lethal virus was first identified in the American Southwest in the early 1990s. A new virus is typically named for the locale where it is discovered. This was a problem for this new hantvirus strain. It was found in the Canyon del Muerto in northeast Arizona, so named for a massacre in the 1800s. Imagine the public reaction to a new, lethal, "Canyon of Death" virus loose in their neighborhood. Thought turned to naming it the "Four Corners" virus, but the local Chamber of Commerce muttered something about tarring and feathering those responsible. It was finally christened the "sin nombre virus," Spanish for "no name." This should have been written lowercase since "sin nombre" is not a proper noun, just a phrase. But the literature soon came to capitalize it as if it were a place name, the Sin Nombre Virus (SNV). The story continues. When in the process of publishing a review paper on the hantavirus my editor changed the capitalization to lowercase in the galley proofs. This was absolutely correct according to the style guides. I sent her portions of six articles from research journals to illustrate the practice of capitalization that had taken hold in the literature. To lowercase the virus name would have been stylistically correct, but it would have discredited the paper, suggesting the author was not in touch with the literature. It was capitalized in the published article. The moral? Use style guides warily when it comes to nomenclature.

The AMA's lead editor makes this charming observation in her preface: "I never cease to be amazed by the general inability of physicians, other health professionals, and scientists to communicate through the written word. Their scholarly and creative ideas and insightful data interpretation of them seem to get lost in the translation from brain to page" (p. v). The quality of medical writing has dramatically improved since a young Dr. Michael Crichton (Jurassic Park, tv's ER) wrote in the pages of the New England Journal that "medical writing is bad, but its functions are perfectly understandable as a display of scientific [editorial?] profundity, not as an attempt to communicate experience" (December 11, 1975;293:1257-1259). Apparently this malaise, and foot-in-mouth disease to boot, now afflicts the AMA's editors.

Curmudgeoning aside, is the 1000-page text usable? AMA style generally dispenses with periods after abbreviations, but if the abbreviation for "saint" is used in a name, as in William St. James, a period is required. If the abbreviation is used with a city in a reference, as in St Louis, no period is needed. Is this the answer to a question you would ever think to ask? What other pitfalls and traps lurk in this massive text? Instructions for the general use of abbreviations are found near pages 450 and 500; those for the use of colons are on pages 34 and 241; and those for numbers are on pages 795 or 850. The text may be well organized for editors, but if you are looking for guidance on the most common problems confronted by a writer, you have a monumental task before you. While there is some useful information for authors in the first 60-80 pages, especially on references, this a tedious volume to work through. It is a reference, not a guide. A reference demands that you know what questions to ask. A guide answers the questions you didn't think to ask. As an author, I need a style guide.

I'm a medical copy editor so this book is an essential reference in my work. The tenth edition presents up-to-date information in, as usual, a somewhat difficult format---the categories and placement of topics therein don't always seem as user-friendly as they might be.
The otherwise excellent chapter "Correct and Preferred Usage" exemplifies the fatal flaw of this manual (if indeed it has one): People who tend to get this stuff wrong typically won't know to look for (or where to look for) help, if only because they don't recognize issues as matters of "usage"---for example, test results, not tests, are negative, but I invariably have to fix this in the books I edit, so obviously it's not getting through to authors, at least some of whom presumably use this manual. (Of course, it's great to have these rules and rulings, but I'm the copy editor so I already know them.)
Also, I don't always agree that AMA style is the best. Reference style, for example, seems too detailed and fussy without any real benefit---six author names? Come on, please.
An odd and illogical choice, to my mind, is use of numbers in terms like "3-dimensional," instead of "three-dimensional." Typically, in medical/scientific discussions using this term, consideration of the number of dimensions isn't the point; it's just three versus two (a descriptive designation, not a measurement), and if a shorter form is needed because of frequent use, then "3D" is the obvious solution.
Another reviewer mentions the lack of consistency in use of periods: "Susan St. James" has a period; "St Louis, MO" does not.
Finally, the index should be more detailed---sometimes it's hard to guess the main entry for whatever it is I'm looking for.
However, the material on genetics is great to have, as are the updates on references material to include electronic sources.