Questions From Users of the Manual

Q: I am used to writing “compared with” when discussing results/measurements. Can you please comment on whether this is correct?

A: This is addressed in the glossary in chapter 11. See “compare to, compare with.” You’ll see there that “compare with” is usually used when the aim is to examine similarities or differences in detail.

Q: I was trained in other settings to ignore having to write out the state on first mention if the city is well known, especially if the readership is primarily American. For example, Chicago, Los Angeles, and San Francisco would not require adding the state name on first mention. Something like Spring Green would. What would AMA style require?

A: Please see section 14.5, where this is addressed in detail. The key sentence is this:  “At first mention, the name of a state, territory, possession, province, or country should be spelled out when it follows the name of a city.” In earlier editions, we used to follow a policy something like what you describe but changed that as it was a matter of opinion what was “well known” and what was not.  Also, with the international readership of so many publications, this becomes a trickier question.—Cheryl Iverson, MA

Questions From Users of the Manual

Q: I note in the manual that you do not require the use of the registered trademark symbol with brand names, as long as an initial capital letter is used (see 5.6.16, Use of Trademark Names in Publication).  Does this guideline apply to copy in medical books as well as medical journals?

A:  You are right that our manual does not encourage the use of the little “R” in a circle or the superscript TM to denote trademarks but rather relies on the initial cap to signify a trademark. As to what style would apply to books (medical or other), it really all comes down to what style the book publisher uses. The Chicago Manual of Style (section 8.152) states: “Although the symbols [cap R in a circle and superscript TM] for registered and unregistered trademarks, respectively) often accompany trademark names on product packaging and in promotional material, there is no legal requirement to use these symbols, and they should be omitted wherever possible.”

I think you would be fairly safe in zapping the symbol and just using the initial cap, unless the style guide you are following in editing a book dictates otherwise.

Q: What do you recommend re capitalization for something like the word “test” or “examination” or “questionnaire” in names of specific tests, examinations, or questionnaires?

A: Our style manual (section 10.3.8) advises the following regarding capping the “t” on “test” when it follows the name of a specific test. I would extrapolate from this to cover similar questions.

Tests.  The exact and complete titles of tests and subscales of tests should be capitalized.  The word test is not usually capitalized except when it is part of the official name of the test.  Always verify exact names of any tests with the author or with reference sources.

Examples where a cap would be correct include the Mini-Mental State Examination and the Minnesota Multiphasic Personality Inventory.—Cheryl Iverson, MA

Questions From Users of the Manual

Q: My colleagues and I are debating the correctness of the following sentence:  If any of the side effects gets serious, contact the study doctor.

A: If you remove the words “of the” from your sentence, you will find the answer(s) readily apparent. If there is one side effect, you’d use the singular:  “If any side effect becomes serious….”  If there is more than one side effect, you’d use the plural:  If any side effects become serious….”

Q: Should “week” or “weeks” be used in the following sentences?

 The changes in serum creatinine remained stable from week/weeks 48 to 96.

Nausea typically develops between the fourth and sixth week/weeks of pregnancy.

A: We would suggest using “weeks” in both examples. It would, of course, not be incorrect to repeat “week,” eg, “…at week 48 and week 96,” but for efficiency you could use “…at weeks 48 and 96.”—Cheryl Iverson, MA

Questions From Users of the Manual

Q: I cannot find anything in the AMA Manual of Style about how to cite an article in a magazine. Please help.

A: You are correct that we do not address citations to magazines, primarily because the material we focus on is more scholarly. However, you could extrapolate from the information on how to cite a journal article (see section 3.11). Here is an example of citation of a magazine article:

Angell R. This old man: life in the nineties. New Yorker. February 17&24, 2014:60-65.

You’ll notice that although we prefer giving the year;volume number(issue number):inclusive pages in our citations to journal articles, some magazines do not use volume and issue numbers but instead rely on the issue date. This seems to be true of the New Yorker, and this article was in a double issue, so you’ll see that I have suggested using issue date:inclusive page numbers.

Q: What is the best way to send a question to you regarding the content of the style manual?

A: You may write to the style manual at

Q: For package insert references, many times the manufacturer and marketing company are the same. However, if they are not, which company should be listed in the reference citation?

A: It might be helpful in the case of a manufacturer and a marketer to list both. In this case, you could separate them by a semicolon:

Onglyza [package insert]. Princeton, NJ: Bristol-Myers Squibb Co; Wilmington, DE: AstraZeneca Pharmaceuticals LP; July 2009.—Cheryl Iverson, MA

Questions From Users of the Manual

Q: Do superscript reference numbers go before or after colons? What about periods and commas?

A: Superscript reference numbers go before colons and semicolons and after commas and periods. See section 3.6.

Q: When will the next edition of the AMA Manual of Style be published?

A: We have begun work on the next (11th) edition but do not yet have a projected publication date. I think 2016 is realistic. In the meantime, I hope you avail yourself of the online updates, which provide policy changes, etc. Those are free, if you do not have an online subscription. The monthly quizzes (which are free to subscribers) are also a good way (between editions) to see more examples.

Q: On PowerPoint slides, how do you recommend citing reference sources: on each slide that is not the presenter’s own, or at the end of the presentation?

A: At present, our style manual does not address style questions related to PowerPoint presentations; however, we are considering adding a few guidelines on this in the next edition. For now, I would suggest adding the reference sources on each slide, as a footer. Because the slides are likely to be pulled apart from the entire presentation and used by others, having the source with the content seems advisable.—Cheryl Iverson, MA

Questions From Users of the Manual

Q: How do you create a “thin space” in Word?

A: In Word, use the shortcut to the ¼ em space character under Insert/Symbol/Special Characters. The Unicode value for the ¼ em space is 2005, and it’s in the General Punctuation section of any Unicode font. The 1/6 em space is also used as a thin space; the Unicode value for that is 2006, and it’s also in the General Punctuation section of any Unicode font.

Q: Is it necessary to include http:// in a URL? What about http://www.? I like to avoid long strings for URLs and if it’s OK to shorten them, that’s what I’d like to do. 

A: The http:// in the URL is only necessary in text to ensure that the reader knows that the information provided is a website. If that information is clear from the context without http://, it is not necessary. To know whether www is necessary or not, you should try the URL without it. Some URLs require the www, while others will not work if www is added. To ensure that the URL is correct, you should check it on the Internet.

Q: Can you please tell me how many journals use the AMA Manual of Style?  Does a list of these journals exist?

A: I don’t have the data you request…and I’d certainly be interested myself. I can tell you that we’ve  sold  almost 30,000 copies of the print book, in addition to site licenses and individual subscriptions to the online book. Although this doesn’t answer your question precisely, the number of copies sold might be of some help.—Cheryl Iverson, MA

Questions From Users of the Manual

Q: How should columns with mixed units of measure indicate the unit of measure?

A: In a table with mixed units throughout, use a table footnote for the most common unit of measure, eg, “Unless otherwise indicated, data are expressed as number (percentage).” and specify in the stub or column head only those units that are different. In a table with mixed units in a single column, use the most common unit in the column head and only provide another unit in the table cell for those entries that have a different unit of measure.

Q: Because of the change from the 9th to the 10th edition in the way number and percentage are handled in running text (see page 832 in the 10th edition), should column headings in tables also be changed to read, for example, “No. of Girls (%)” rather than “No. (%) of Girls”?

A: No. The style “No. (%) of Girls” is still an acceptable table column head as here both “number” and “percentage” apply to “of girls,” whereas in the example on p 832, the percentage is given as more of an aside to the numerator and denominator and hence follows: “Death occurred in 6 of 200 patients (3%).”

Q: What recommendations do you have for the preferred typeface of a punctuation mark that follows copy set in something other than roman type?

A: Some specific recommendations are outlined below:

• If an entire sentence is set in a typeface other than roman (eg, italic, bold), any punctuation in that sentence would take the typeface of the rest of the sentence.

• If part of a sentence is set in a typeface other than roman, even if it’s the end of the sentence, the ending punctuation would be roman.

• For heads, sideheads, entries in a glossary, the punctuation would follow that of the preceding word (so, in Correct and Preferred Usage of Common Words and Phrases, the commas between the word pairs are boldface, like the words).

• For parentheses and brackets, unless the entire sentence is set in a typeface other than roman, the parentheses or brackets are roman (see the example with “[sic]” on p 358).—Cheryl Iverson, MA


Questions From Users of the Manual

Q: If there is a column for P values in a table and if a P value “straddles” rows (eg, provides the P value for men vs women), how should this be shown?

A: There are several options, with option 1 being preferred:

1. Center the P value between the items it compares (eg, between the values for men and women) and consider the use of a side brace.

2. If only 2 items are being compared, list the P value on the line giving the overall category (eg, Sex).

3. Use footnotes to indicate the P value for items being compared (eg, use a superscript “a” next to the value for men and the value for women and indicate the P value for this comparison in a footnote labeled “a”).

Q: If some of the confidence intervals given in a table column include negative values, how do you combine the minus sign and the hyphen that would normally be used in such a range in a table?

A: With ranges that include a minus sign, use to to express the range, rather than a hyphen. Carry this style throughout the entire table, even for those values that do not include a minus sign.—Cheryl Iverson, MA

Questions from Users of the Manual

Q: I’ve been searching the 10th edition to see where the list of footnote symbols from the previous edition is given and I cannot find it. Is that because the lowercase alphabet letters are now going to replace these symbols, as mentioned on page 91?

A: Yes, almost right. We have changed our policy on using superscript symbols for table footnotes and are now using superscript lowercase letters. There are more of them and they are not so “odd.” However, we are continuing to use the old “footnote symbols” for bottom-of-the-page footnotes (see p 43). We only show 2 here…the asterisk and the dagger…because it is not likely that more would be needed (this is the only type of bottom-of-page footnotes that we use in our journals), but if you were to require more, the “old” list would still apply.

Q: I haven’t been able to locate in the 10th edition the place where it says that the symbols “greater than” and “less than” should not be used in running text. (It’s at the top of p 256 in the ninth edition.)

A: You are correct. We neglected to include that this time, but the policy is the same. The examples on page 399 illustrate this, but having the specific statement would be good. It’s a bit like the policy we have of reserving the use of the hyphen for ranges to within parentheses and in tables (and, of course, in references, for the page ranges) and not using it in running text (P values are another exception). It all has to do with “elegance.”—Cheryl Iverson, MA