V37 N4 / 2022 ©2022 American Medical Writers Association. All rights reserved. ISSN 2163-5315 AMWAJournal.org 44 “A word after a word after a word is power.” – Margaret Atwood Words are powerful. They may deceptively look like simple little strings of letters, but they hold the tremendous power of influence. The words we choose—and where we place them—influence thoughts, emotions, and behaviors. Clear words support clear thinking. And clear writing and clear thinking go hand in hand. Yet, some writers will throw words on the page, hoping that readers will “get the idea.” But when you use words that are ambiguous, inaccurate, or imprecise, you encourage ambiguous, inaccurate, and imprecise thinking. This careless- ness can cause death by a thousand cuts—each word misuse can chip away at the clarity and credibility of the work. This chipping away can involve any one of the hundreds of thousands of words in the English language. But as a pro- fessional editor, I have noticed 5 words that are most com- monly misused in medical writing: utilize, increase, level, while, and comprise. UTILIZE Many writers write utilize as a synonym for use. But these words have different meanings. Use generally means to put something into action or service, whereas utilize means to make use of. Although these definitions may seem similar, the definition of utilize can suggest the discovery of a new, profitable, or practical use for something. As a general example, imagine—or maybe you can simply recall a recent memory—that you need to remove ice from your windshield, but you don’t have an ice scraper. You might utilize a kitchen spatula for the task. The spatula was not designed to remove the ice, but it does the trick. In science and medicine, you might utilize something for a purpose that it was not designed to fulfill, such as a Petri dish for storing office supplies or a belt for a medical emergency. To ensure your writing is clear, default to writing the word use, and only write utilize when the term is the more accurate choice. Better yet, skip the word utilize altogether, and stick with the more readable word use, which can always replace utilize. Examples The researcher used a Petri dish to grow bacteria. The researcher utilized a Petri dish to store paperclips on their desk. The researcher used a Petri dish to store paperclips on their desk. The emergency responder used a band of rubber as a tourniquet. The emergency responder utilized a belt as a tourniquet. The emergency responder used a belt as a tourniquet. INCREASE Many writers use the term increase (or, conversely, decrease) to describe differences in data. However, they do not always consider nuances in the meaning of this term. Increase means to make or become progressively greater in size, amount, number, or intensity. Based on this defini- tion, increase infers a change over time or a cause-effect relationship. But what many writers do is misuse increase to describe differences between groups of data. Most often, this misuse looks like increase paired with versus, than, compared to, or compared with. In these cases, the more accurate phrasing would be to use higher or greater. To ensure accuracy in your writing, only use increase when referring to changes over time or a cause-effect rela- tionship. And use higher or greater to refer to differences between groups of data. Examples The prevalence of diabetes increased from 0.93% in 1958 to 7.4% in 2015. Epinephrine increases heart rate and cardiac output. Urine albumin was higher in patients with kidney disease than in healthy patients. The concentration of red blood cells was greater in patients treated with the drug versus those who took a placebo. High sugar consumption for 4 weeks increased body weight by 1 pound each week. Crystal R. Herron, PhD, ELS / Redwood Ink, LLC, San Rafael, CA The 5 Most Commonly Misused Words in Medical Writing (According to an Editor) CONSCIOUS WRITING http://www.amwajournal.org AMWAJournal.org 45The 5 Most Commonly Misused Words in Medical Writing The drug increased liver function in patients with hepatitis C. LEVEL Some writers use level as a synonym for the words amount, concentration, or content. These latter 3 words have fairly simple definitions. Amount means the total number or quantity. Concentration means the amount of a component in a given area or volume. And content means the amount of a specified material. But the definition of level is not as simple. In fact, level has several meanings, including a concentration of some- thing, a position in a scale, a measurement or index of altitude, or the magnitude of a quantity related to another value. Level can also be used to refer to even or unvarying height, or to a device that helps to establish a horizontal line or plane. All these different meanings can create confusion for readers. To ensure that the writing is clear and easy to under- stand, default to using amount, concentration, and content. Only use level when no other word will do. Examples The treatment increased the concentration of antibodies in the blood stream. The drug reduced the amount of tumor necrosis factor. The bone was leveled during the osteotomy. WHILE While is another word that can trip up writers. Many writers use while, although, and whereas interchangeably. But while is not an accurate synonym for although or whereas. Although means in spite of something or even though, and whereas means on the contrary or in view of. These definitions are fairly straightforward. The definition of while is not as straightforward because the word has multiple meanings. While can mean during a certain time, as long as, on the other hand, and at the same time as something. These definitions mean that while can sometimes be used instead of although or whereas, but not always. Even still, why risk confusing readers by making them figure out which meaning of while you intend? To ensure clarity, use while only when referring to time. Otherwise, use a term with a more precise meaning, such as although or whereas—or even a more readable word such as and or but. Examples The pharmacist prepared the prescription while the patient waited in the lobby. Although the patient adhered to the treatment plan, their insomnia persisted. Drug A reduced blood pressure by 10%, whereas Drug B reduced blood pressure by 15%. The resident performed the surgery, and the attending oversaw the procedure. The drug slowed heart rate, but it did not lower blood pressure. COMPRISE Many writers misuse the word comprise in their writing. How? They erroneously follow comprise with the word of. In these cases, writers are likely confusing comprise with the term compose. But these terms have opposite meanings. Comprise means to include or be made up of (ie, A com- prises X, Y, and Z), whereas compose means to form by put- ting together or to constitute (ie, X, Y, and Z compose A). To give compose a similar meaning to comprise, the word must be sandwiched between a weak “to be” verb (eg, is, are, was, were) and the word of (eg, was composed of). Alternatively, writers may use comprise as a synonym for consists. Unlike with compose, comprise and consists have similar meanings. Comprise means to include or be made up of, and consists means to be composed or made up of. But, grammatically, only the word consists should be fol- lowed by the word of. To ensure clarity and accuracy, use comprise without of, or use consists instead. And if you are tempted to use the sandwiched form of compose, stick with either comprise or consists to reduce the word count and give your sentence a little readability boost. Examples The complex is composed of 3 proteins. The solution consists of 4 chemicals. The team comprises a physician, nurse practitioner, and resident. KEEPING UP WITH CHANGE Language constantly evolves, so the meanings of these words and how they are used may change in the future. The key is to stay updated on these changes so that you can use the most explicit, accurate, and precise words in your writing. In this way, you can harness the full power of words to craft clear writing that supports clear thinking and credible work. Author declaration and disclosures: The author notes no commercial associations that may pose a conflict of interest in relation to this article. Author contact: crystal.herron@redwoodink.com http://www.amwajournal.org