Reader TTS

You have full access to this article via your institution. Download PDF The practice of using abbreviations dates back to Roman times. But the frequency of their use seems to have increased

over the past few decades. In 1990, Conti1 listed 18 different acronyms for clinical trials using a single intervention—thrombolytic therapy for myocardial infarction. Several authors and

editors2 have discouraged the use of acronyms in general, inappropriate or coercive acronyms for naming clinical trials in particular.3 Many adjectives have been used to describe the

affinity for using excessive number of acronyms, some of which include, “a malignant disease of acronymophilia,”4 “acronym diarrhea disorder,2” “acronymophobia,” “a bureaucratic infectious

disease, or buropathy.4” Below, I provide an example of this malady in a hypothetical abstract. “In this study of children of HELP mothers, we found that their teacher assisted ILS were

suboptimal. However, all of them scored optimally in P-CLIP. This paradoxical outcome is significant because it suggests that if children’s teacher assisted ILS could be improved, such

children may improve their scholastic achievements, overcome SPP, and achieve their FPFLA. These improvements can increase their chances of graduating from HS.” To understand the above text,

the reader must refer to the list of abbreviations, if provided, or wade through the manuscript to find the first use of the acronym with its expanded version. Then, the above abstract

would read as follows: “In this study of children of healthy, English-language proficient mothers, we found their teacher-assisted interactive language skills were suboptimal. However, all

of them scored optimally in parent-child language interactive processes. This paradoxical outcome is significant because it suggests that if children’s teacher-assisted skills could be

improved, such children may improve their scholastic achievements, overcome severe peer pressure, and achieve their full potential for language acquisition. These improvements can increase

their chances of graduating from high school.” It is unlikely that any medical journal would accept such an acronym-filled abstract as the one above. But I use this to underscore readers’

frustration trying to decipher the meaning of scientific papers filled with stumbling acronyms. Although used synonymously, the words abbreviation, acronym, and initialism have different

meanings. An abbreviation is a blanket term for any shortened or truncated word of a multi-word term or phrase, as in “btw” for “by the way” or “cc” for “carbon copy” often used in emails or

social media exchanges. An acronym is a specific type of abbreviation formed from the first letters of a multi-word term, name, or phrase, which is pronounced as a single word, as in ELISA,

AIDS, or UNICEF. An initialism is an acronym, but the individual letters are pronounced separately, as in DNA, PCR, or ADHD. To find out the earliest date since medical journals allowed

acronyms in scientific papers, I scanned three inaugural issues from each of the three pediatric journals: Journal of Pediatrics that began in July 1932, Pediatrics that began in January

1948, and Pediatric Research that began in January 1967. I scanned the issues for acronyms in research papers, review articles, case reports, committee and conference reports, and scientific

comments and editorials. Among the 108 publications, I found two abbreviations: “TAF” for “Toxin-Antitoxin Floccules,” a commercial product to enhance immunity in infants with diphtheria in

the first issue of Journal of Pediatrics, and “ATP-ase” in the first issue of Pediatric Research. I scanned issues from the same journals over the subsequent years and found very few

abbreviations until the decade of the 1980s. By the mid-1980s, lists of abbreviations began to appear in all three pediatric journals. It is likely that other journals, too, began this trend

of accepting manuscripts with acronyms along with an abbreviations list. We do not know why such a trend started, but it has persisted. Now there are even databases of medical journal

abbreviations. Is it time for medical journals to eliminate all abbreviations in publications? What would be the tradeoff from such a drastic change in the publication of scientific papers?

The obvious benefit of using abbreviations, especially for recurring phrases, would be the reduction in the length of the published papers, allowing more articles to be included without

increasing the number of pages per issue. Reduced size of the issues would reduce the cost of production and postage. Fewer pages per issue could benefit the ecosystem by minimizing the use

of paper products. Medical libraries, too, might welcome thinner journals that require less storage space. However, those advantages may be less relevant in today’s electronic age. Most

journals have switched to electronic publications. Some that continue with print versions are restricting to publish only the tables of contents and abstracts, providing full-length versions

electronically. Readers’ habits, too, have changed. With near universal use of hand-held electronic gadgets, we can access journal articles from any place within minutes. Journal

subscribers rarely receive printed journals, since electronic versions are easily accessible. Libraries, too, are converting printed journal volumes and books into PDF versions. Therefore,

there is no advantage in trying to reduce manuscript length by allowing multiple abbreviations. What are the drawbacks of using too many acronyms? Abbreviations that are unique and

article-specific hinder the ease of reading, affect comprehension, and could lead to misunderstanding. Tsafrier reported that in her MEDLINE search for the phrase “serum thymic factor,” or

STF as its abbreviation, she stumbled upon 21 different phrases, all shortened to STF in the titles or abstracts. Multiple factors affect comprehension of the words associated with acronyms,

as the works by Playfoot and Izura show. While some readers can recognize words associated with acronyms easily, others may not, because acronyms recognition is affected by age of

acquisition and imageability, as well as by the relationship between spelling and sound—a pattern not usually observed in word recognition.5 Imagine the annoyance if we encounter

abbreviations in newspaper or magazine articles, in books of poems, or novels and stories. Why should we accept scientific articles replete with acronyms affecting the ease of reading and

comprehension, or even causing misunderstanding? As editors of some journals have recommended, it may be time for medical journals to instruct authors to eliminate all non-standard acronyms,

especially those that are unique to the submitted manuscript. Journals may allow some well-known and easily recognizable acronyms, such as RADAR, AIDS, LASER, or UNESCO or initialisms such

as DNA, MRI, EEG, or WHO. Wouldn’t an uninterrupted, acronym-free scientific paper be a joy to read? REFERENCES * Conti, C. R. Acronyms of thrombolytic therapy in myocardial infarctions.

_Clin. Cardiol._ 13, 1–2 (1990). Article  CAS  PubMed  Google Scholar  * Begg, C. B. Zero tolerance for acronyms. _Clin. Trials_ 14, 561–562 (2017). Article  PubMed  Google Scholar  * Cheng,

T. O. To use BEST as an acronym for another cardiological trial may not be the best idea. _Int. J. Cardiol._ 124, 227 (2008). Article  PubMed  Google Scholar  * Isaacs, D. & Fitzgerald,

D. Acronymophilia: an update. _Arch. Dis. Child_ 83, 517–518 (2000). Article  CAS  PubMed  PubMed Central  Google Scholar  * Playfoot, D. & Izura, C. Imageability, age of acquisition,

and frequency factors in acronym comprehension. _Q. J. Exp. Psychol._ 66, 1131–1145 (2013). Article  Google Scholar  Download references FUNDING Funding T.N.K.R. is an employee of the United

States Federal Government, at the National Institutes of Health (NIH), USA. The current work was carried out within the context of his official duties. His employers had no influence on the

contents of the current article. AUTHOR INFORMATION AUTHORS AND AFFILIATIONS * National Institutes of Health, Bethesda, MD, USA Tonse N. K. Raju Authors * Tonse N. K. Raju View author

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ARTICLE Raju, T.N.K. The tyranny of acronyms in medical journal articles. _Pediatr Res_ 95, 859–860 (2024). https://doi.org/10.1038/s41390-023-02797-7 Download citation * Received: 09 August

2023 * Accepted: 16 August 2023 * Published: 06 September 2023 * Issue Date: February 2024 * DOI: https://doi.org/10.1038/s41390-023-02797-7 SHARE THIS ARTICLE Anyone you share the

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