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Troublesome Words


  • Affect as a verb means to have influence on. Effect as a verb means to bring about or cause
  • Affect as a noun refers to an immediate emotion. Effect as a noun means result

Injecting ascorbic acid may affect his recovery

In the drug-treatment group, constipation, headache and nausea were the most commonly reported adverse effects

Among / between
  • Use between when referring to two items and among for more than two

There were no differences among the three treatments studied

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  • Both is used only when discussing two things, e.g.

Patients reported both headaches and nausea

‘Patients reported both headaches, nausea and dizziness’ would be wrong


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Case, patient
  • A case is a particular instance of disease. A patient is a person who is ill. A case is evaluated and reported but does not have symptoms. A patient is admitted to the hospital, examined, given medication, recovers
Compared with / compared to
  • ‘Compare to’ should be used to liken things (a simile), ‘compare with’ to consider their similarities or differences. Compare with is usually the term required

Shall I compare thee to a bunch of grapes?

Oasis have often been compared to Blur

The low-fat diet was compared with the high-fat diet

Plasma glucose levels in Quartile 1 were comparable to those in Quartile 2

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Dependant / dependent
  • Dependant is the noun (for example, a child is a dependant); something that depends on something else is dependent

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Fewer / less
  • Fewer is used for number (counted and countable items) and less for quantity (uncountable and uncounted quantities). e.g. fewer than nine items, fewer interventions, less than 300 g, less than 20%, less information, fewer interventions may not always mean less care
Former / latter
  • Use former and latter only if you are referring to one of two previously mentioned items

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  • Gender is a cultural term and sex is a biological term. Raise a query to check with the authors whether ‘gender’ should be changed to ‘sex’ or vice versa. This may depend on the context—gender may be more appropriate in some psychological or sociological contexts. In addition, the authors should report the demographics as they’ve been collected, so if the original data are collected as self-reported gender, then the authors would need to continue to use this term. It is possible that someone who identifies as a women (gender) may also be male or intersex (sex) and vice versa. Note also that, when referring to gender, the terms ‘women/men’ are preferable to ‘female/male participants’

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  • Use included to introduce a list of criteria only if the list is not complete. Otherwise use ‘the criteria were … ‘

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Led / lead
  • Led is the past tense of to lead. The spelling lead that is pronounced led is the metal
Licence / license
  • Licence is the noun (the licence was issued last year) and license is the verb (the drug was licensed last year)

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May / might
  • May is used if there is more than one possible outcome. Might is use to discuss something that could have happened but didn’t because a condition for its happening was not fulfilled. For example: The mice might have been healthy if they had been given zinc
  • May and might can also be used to indicate degrees of tentativeness: The conclusion may be wrong
  • The choice of may or might can change the meaning: Changing the insulin regimen might have saved the patient (the patient is dead, but if the insulin regimen had been changed, it is possible that the patient would have survived). Changing the insulin regimen may have saved the patient (implies that the patient survived, possibly because of the change in the regimen)

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Neither / nor
  • A sentence that contains neither must also include nor (the treatment was neither effective nor safe). ‘Nor’ can be used in a sentence that doesn’t contain ‘neither’ (the drug should not be prescribed, nor should it be stored by the pharmacy)

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Practice / Practise
  • Practice is the noun (a doctor’s practice). To practise is the verb (a doctor who practised medicine)

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  • • See ‘Gender/sex’ above

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That / which
  • A restrictive (or defining) clause ‘completes’ the subject and is consequently indispensable. By contrast, a non-restrictive (or commenting) clause does no more than give additional information. A non-restrictive clause should be within commas, a restrictive one should not
  • ‘That’ introduces a restrictive clause (This is the house that Jack built); ‘which’ introduces a non-restrictive clause and is offset by commas (This house, which Jack built, was of shoddy construction)
  • Use of the terms ‘trend’ or ‘tended to’ should not be used to describe data that do not reach the threshold for significance. If authors have used these terms without clarifying the significance level or including p values, a query should be raised. Note that the term ‘trend’ is fine in connection with p for trend, or where discussing changes over a time course.

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Utilise / usage In its strictest sense, utilise means to make the best use of something that wasn’t intended for the job (‘He utilised a coat hanger to repair his car’). It can be legitimately extended to mean making the most practical use of something (‘Although the hills were steep, the rice farmers utilised every square inch of the land’), and is used in certain biological contexts such as ‘glucose utilisation’; in most other senses ‘use’ is better

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