Settling a usage, punctuation or grammar question

Usage questions can require grammatical analysis, a dictionary, a style manual or evidence of actual use. These references answer different questions, and a disputed expression can be an established idiom or a matter of preference.

Dictionaries and actual usage

Dictionaries reflect changes in language rather than simply controlling them, so medical writers should keep abreast of changing definitions and new words. ¹ Figurative “literally”, used to strengthen a metaphor, appeared in nineteenth-century writing by Dickens and Louisa May Alcott and was included in an Oxford English Dictionary definition reported in 2013. ¹

Absence from a dictionary does not establish that a term does not exist or is not widely understood. ² “Evaluable” can meet a need more economically than “capable of evaluation”; its use was documented from 1880 before its later dictionary admission. ^{3, 2}

Corpus searches can establish that a disputed construction is used. ^{2, 4} A search reported in 2015 of SpringerExemplar, containing more than nine million documents, found more than 117,000 articles matching “timepoint”, “time-point” or “time point”, with first use in 1953; about 115,000 were reported in medicine and public health, biomedicine, life sciences, oncology and general biochemistry. ² The count excluded regulatory documentation, where the term was also familiar in practice. ²

A search of the same database found more than 92,000 hits for “diagnosed with” and just under 17,000 for “was diagnosed in”. ⁴ The vague search terms supported the conclusion that both formulations were common, rather than a judgement that one was correct and the other wrong. ⁴

Prepositions are especially dependent on idiom and place substantial demands on speakers, writers and translators when expressing fine relationships. ⁵

References for punctuation questions

Several reference works address different levels of punctuation guidance. ^{6, 7, 8, 9}

• Lynne Truss’s Eats, Shoots & Leaves offers a journalistic introduction through everyday examples, historical anecdotes and punctuation rules, suited to readers who avoid dry grammar textbooks. ⁶
• The Penguin Guide to Punctuation gives practical basic guidance on individual marks, with brief sections on abbreviations and capitalisation, and explains British and US differences without taking sides. ⁷
• The Chicago Manual of Style addresses more complex questions: commas with adverbial clauses and phrases, brackets and dashes, compound words and affixes, bulleted lists, quotations, and abbreviated names, titles and degrees. ⁸
• The AMA Manual of Style addresses medical-text details including table headings, words preceded by numerals, Greek letters or per cent signs, eponyms, and enumerations and bulleted lists. ⁹

The Chicago and AMA manuals provide guidance on controversial questions rather than universal truths. ^{8, 9}