Eschew Obfuscation: Writing in Plain Language

​“If you can‘t explain it simply, you don‘t understand it well enough.” -Albert Einstein

I edit so many research papers in which the writers take the most convoluted and circuitous routes to get a simple point across. Instead of being impressive and scholarly, it is just confusing. Your writing is more effective—and your reader can actually understand it—when you use plain language.
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The “Dizzy Awards” have been given out by the Texas Heart Institute Journal for the past 30 years for excellence in “unintentionally comical, bewildering, or downright terrible” medical writing (they don’t name names). Check out this gem that was published in a prominent medical journal:

​“The development of Goodpasture’s disease may be considered an autoimmune ‘conformeropathy’ that involves perturbation of the quaternary structure of the A345NC1 hexamer, inducing a pathogenic conformational change in the A3NC1 and a5NC1 subunits, which in turn elicits an autoimmune response.” (2012 Dizzy Award Winner)

If the reader has to re-read each paragraph multiple times to understand your point, you have lost them. Writing in plain language is not a “dumbing down” of your work—it is ensuring that your reader will understand it the first time that they read it.

Writing in plain language is a lot harder than it sounds. You may have heard this quote: “If I had more time, I would have written a shorter letter.” It is actually quite difficult to write in plain language. But I am here to give you some tips and tricks!

Use short sentences
A general rule of thumb is to keep your sentences to an average of 20 words or fewer with one idea per sentence. This is especially true for the lead sentence in a paragraph. If your sentences are running multiple lines with many commas and/or semicolons, break them up into smaller sentences. Longer sentences are not forbidden—just try to keep most short for easier reading. Below is an example of the type of sentences I see all the time (shiver!). This one should have been a short sentence and a concise table:

“The greater pain caused by larger-size tubes was the result of increased pain during the insertion of the tube and pain while the tube was in situ, with no pain difference during tube removal (insertion: size < 10F, MPS 2 [IQR 1–2]; size 10–14F, MPS 2 [IQR 1–3]; size 15–20F, MPS 2 [IQR 1–3]; size > 20F, MPS 2 [IQR 2–3]; χ2, 3 df = 8.12, P = .044, Kruskal-Wallis; χ2 trend, 1 df = 7.2, P =.009. in situ: size < 10F, MPS 2 [IQR 1–3]; size 10–14F, MPS 2 [IQR 1–2]; size 15–20F, MPS 2 [IQR 2–3]; size > 20F, MPS 2 [IQR 2–3]; χ2, 3 df = 11.75, P = .008, Kruskal-Wallis; χ2 trend, 1 df = 6.2, P = .015. removal: size < 10F, MPS 2 [IQR 1–2]; size 10–14F, MPS 1 [IQR 1–2]; size 15–20F, MPS 2 [IQR 1–2]; size > 20F, MPS 1 [IQR 1–2]; χ2, 3 df = 2.7, P= .44, Kruskal-Wallis; χ2 trend, 1 df = 1.0, P = .31 (Fig 2).” (2010 Dizzy Award Winner)

Use the active versus the passive voice
In the active voice, the subject does the acting; in the passive voice, the subject is acted on. For example, “constipation is reported in over 33 million adults…” (2009 Dizzy Award Winner) should be “33 million adults reported constipation…” (and reports can’t appear in patients!).
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Use common, everyday words
Basically, use the simplest word for the job. For example, use “use” versus “utilize.” Technical terms are fine, but be aware that your reading audience may come from different research areas or other countries that use different technical terms. Rule number two in George Orwell’s Six Rules for Writers is “never use a long word where a short one will do” and number five is “never use a foreign phrase, a scientific word, or a jargon word if you can think of an everyday English equivalent.”  Listen to George, he knows what he is talking about.

Define all of your abbreviations or acronyms on first use
Sure, it may be a common abbreviation used by everyone in your nuclear physics lab, but be aware that people from outside your lab or from other countries may use different ones. People from other specialties may use the same acronym for an entirely different term. In medicine, “CA” is the abbreviation for cancer, cardiac arrest, chronologic age, contrast angiography, and others. Avoid confusion and define your terms. And remember to define on first use in both the abstract and the body of the paper.

Avoid using abbreviations or acronyms for convenience
Many authors will devise their own sets of abbreviations or acronyms for use in a single paper. These ones are not in common use and are devised by the author so that they do not have to write certain phrases over and over again (lazy!). For clarity, keep the terms expanded. The exception to this is in tables where space is at a premium. Even then, the abbreviation(s) should be clearly defined in the caption or in a footnote. For example, in “Because it is both a common and serious condition, elderly nursing home (NH) residents are…” (2010 Dizzy Award Winner), nursing home should be left expanded—and being a resident is not a common and serious condition to top it off.

Write in the positive versus the negative
Each negative term used obscures the clarity of your message exponentially. Look at these examples:

• “Unlike salicylates, we are unaware of any case reports…” (2009 Dizzy Award Winner)
• “In contrast to the urinary tract, hepatobiliary tumors infrequently cause bleeding in the biliary tract.” (2012 Dizzy Award Winner)

It is much clearer to say “There are many case reports for salicylates…” and “…hepatobiliary tumors rarely cause bleeding…”

Avoid redundant and ambiguous words
Phrases such as fewer in number, future plans, and sum total are all redundant (i.e., both words mean the same thing). An example of redundancy is the “one solitary” used in this sentence (and is there an Alcoholic Skeletal Myopathy Journal for this to be described in?):

​“Except for one solitary case, acute cardiac dysfunction has not been described previously in alcoholic skeletal myopathy.” (2010 Dizzy Award Winner)

Finally, your spellchecker is your friend. Don’t forget to use it. There are also a number of other programs and macros that can be used to spot and correct problems, but that is another adventure.

​Happy adventures in editing!