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Medical journals: Stop being so passive

October 14, 2010
  • By Patrick J. Skerrett, Former Executive Editor, Harvard Health

About the Author

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Patrick J. Skerrett, Former Executive Editor, Harvard Health

Pat Skerrett is the editor of STAT's First Opinion and host of the First Opinion podcast. He is the former editor of the Harvard Health blog and former Executive Editor of Harvard Health Publishing. Before that, he was editor of … See Full Bio
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January 10, 2012

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October 11, 2011

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Leslie Nolen - The Radial Group
September 17, 2011

Treating this topic as strictly a readability issue trivializes it (and I wish I had seen the original post at the time!).

Sure, poorly-written, dry, tedious articles prevent effective communication. No argument, that’s bad.

Much more important, however: passive voice and many of the other most annoying writing tics we see in journal articles allow the writers to hedge what they’re saying, avoid taking clear accountability and responsibility for their observations, and avoid stating strong conclusions.

The result: watered-down, soft-soaped articles for reasons that have nothing to do with the quality of supporting data.

Statements like “Mistakes were made” avoid assigning specific accountability for actions or their absence. Far more meaningful and actionable to say: “The attending did not….” or “The charge nurse should have…” or “The patient decided to…”

Statements like “It was observed” distance researchers from the design and results of their work, positioning them as folks watching from a distance rather than the key decisionmakers. Who observed? Was it the lead researcher? A graduate student? An unpaid undergrad required to provide lab assistance as part of a class?

And weasel-worded mushy-middle statements like “It may be said” should make us ask: “Really? Should it in fact be said, or not? To what extent did the data support this? If the data didn’t strongly support this, why are you coyly hinting at it without appropriate caveats?”

Cammie Iacuzio
September 11, 2011

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August 16, 2011

Communication is only effective if the other person receives and understands it in the way you intended, so just writing your information without paying attention to its readability defeats the purpose of your writing.

Mary Albert
February 25, 2011

I like to write just as if I was sitting across from the table from you.
[URL removed by moderator]

Bob Freeman (
January 15, 2011

Information exists to be shared. When it’s written so dry no one wants to read it. It’s a tough balance, you can’t make it too relaxed, however we are far from there. We need information to be interesting so it’s spreads and people can share ideas.

Michael Field-Dodgson
January 1, 2011

Excellent article – having been trained as a scientist and undertook scientific research for more than a decade before turning to commerce I understand both sides of the fence.

On the one hand when you write up a research paper for inclusion in a peer reveiwed scienticic journal, it is refereed so that the prose is as definitive as it can be and any ambiguity is removed. That is, a statement like: “The temperature increased ……” is incorrect because the word temperature cannot increase, so we write:”The temperature value increased…….”

The result to the non-scientist is dry, rather staccato like prose with wierd words making the article unintelligible.

If scientists are writing for public consumption in popular article format then there is no need for the prose to be dry etc. They need to become story tellers in the active voice, informing the public of what they found and the significance of this in adult, but non-scientific prose.

I think it is lazy on their part for scientists to not relate to the sort of prose the public expect to read.

R Moss
December 18, 2010

I was a psychology major for three years back in the 70’s and a mandatory course was in scientific writing. We were taught to write in this manner and, to be honest, it’s one of the reasons I changed majors. There is no reason why scientific and medical studies can’t be made more people-friendly.

Maria Esposito
November 28, 2010

There’s more than just the issue of passive voice. Writings in peer-review journals have convoluted sentence structure and insider jargon/abbreviations, too.

All of that is fine when you’re talking peer-to-peer; the issue of readability comes into the picture when the layperson goes online to read one of those journals. As a medical journalist, I’ve become immune to the problem, but it took a long time.

What compounds the problem even more is that the medical profession has told us we have a right to understand what is being done to us. Many savvy consumers want to know not only the present, but also what may happen in the future.

Some medical journals have tried to compensate for the problem by publishing patient summaries of select research. However, the summaries are written as though they were aimed at children just learning to read their first “chapter book”.

The best solution, in my opinion, is to have an intermediary between the researchers and the layperson – someone to explain the trial using readable sentence structure and without the insider language.

I have started doing that in my blog and the results have been amazing. I have a number of people reading it and my posts are translated into other languages. Why, because all the average person wants to do is exercise the right to know that you (the medical profession) told us we have.

Tracy Allison Altman (
November 4, 2010

Excellent piece. The ‘plain language’ movement – which mandates the use of plain language in government publications – must be extended to writing in medical journals. As you explain so well, our tax dollars are supporting publication of research that is cryptic and difficult to understand.

Besides making the research/evidence more accessible, better writing can reduce the need for others to translate findings into plain language, streamlining the process and hopefully reducing the likelihood of errors or misinterpretation.

Well done. I wrote about your article on today in “Hey you, the one with the scientific evidence. Enough with the passive writing already!”

-Tracy Allison Altman, PhD
Editor @ Evidence Soup

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