To Period or Not to Period

Periods and italics are often a topic of discussion with my clients. Outside of their use at the end of sentences, traditionally periods have been used to denote abbreviations. Italics have traditionally been used to indicate a foreign language word. However, in recent years, various style guides have started to eschew periods and italics in these contexts.

According to the most recent American Medical Association (AMA) style guide (9th edition, 2007), periods should rarely be used outside of indicating the end of a sentence. For example, periods are not required for Latin abbreviations such as etc, eg, ie, and et al. These words also do not need to be italicised. Roman lettering is perfectly acceptable for foreign words currently in common English usage, including the phrase in vitro.

As well, periods are also not required for acronyms like WHO, HIV, or NCIC. However, remember, the first time an acronym is used in a text it should be expanded. For example, "The World Health Organization (WHO) recently reported...."

On the other hand, periods should be used if you are quoting material from another source that used periods. Periods are also used for the initials in names.

When in doubt, always refer back to the most recent edition AMA style guide.

Source: Iverson C, Christiansen S, Flanagan A, et al. American Medical Association Manual of Style. 10th ed.New York, NY: Oxford University Press, 2007.

From the Horse's Mouth

For those of us who write materials that get submitted to the Pharmaceutical Advertising and Advisory Board (PAAB) for approval, navigating the PAAB code is a daily facet of life. Learning the PAAB code and how it applies to each individual piece is an on-going process; and remembering how the code applies in specific circumstances can be a constant mnemonic challenge.

Fortunately, the Pharmaceutical Marketing Club of Quebec (PMCQ) has a great feature on their website to help called Ask PAAB. Here we can peruse an long list of answers to questions commonly-asked to the PAAB. You can also anonymously ask the PAAB your own question via the website.

Not only is this a great tool to keep track of common queries, but it is also a great study tool to learn or review the PAAB code. Simply bookmark the website, and try to answer a question each day starting from question 1. When doing this exercise, don't just rely on your memory; actually look for the asnwer in the code. Then, after reviewing the answer provided by the PAAB, open the PAAB code again to review the sections of the code that were refered to in the answer.

Currently there are 64 questions in the Ask PAAB FAQ. At a rate of one per business day, this is already a three-month program!

Looking It Up

One of the tricks of researching information on topic is to start with a very recent review paper and then to follow the references in the text backward to the original articles. You can then look at the abstracts to see if the article may be useful before purchasing it.

Finding the abstract for an article when you have the citation is easy with the Single Citation Matcher on PubMed. You don't even need to have the full citation for the matcher to work. I have succesfully used the Single Citation Matcher feature when all I've had is an author name and publication year vaguely recalled from the head of a contributing author.

1. From PubMed home page, click on Single Citation Matcher on the left navigation bar. This will take you to the single citation matcher page.
2. Enter whatever information you have about the article that you wish to find in the appropriate search boxes in the form
3. Click 'Go'

It really is that simple.

Basic Word Processing Skills

As a freelancer, I'm often asked to pick up projects that other writers have started. I'm always shocked when I come across documents where the writer has obviously not been trained in even the most basic word processor functions.

As professional writers, the word processor is our tool of the trade, our instrument, in much the same way that an extended ruler is a tool of the carpenter, or the piano is the instrument of the pianist. So why do many writers not take the time to learn their instrument? It would be inconceivable that a graphic artist these days not know how to use a graphic design application or illustration software; so why is it still acceptable for a professional writer to be unfamiliar with the basic features of word processing software?

I'm not saying that all writers should be experts in Microsoft Word or other word processing programs, but we should at least know the basics, such as page breaks, setting tabs, using styles, and creating tables of contents. If we're working with revisions, I believe that we should also be familiar with track changes and comments.

For those of us using MS Word, the Microsoft website has some great tutorial programs on the basics of this word processor, as well as its more advanced features. Here are some that I recommend to my students and junior writers:

Get to know Word: Create your first document
Tables I: Create and format basic tables
Format your document with styles
So that's how! Great Word features

Most of the tutorials can be done in about half an hour if you have some familiarity with MS Word, or about an hour if Word is completely new to you. Set aside a 30 minutes time block each week to devote to learning your instrument, and you'll be moving beyond the basics and wowing your clients with your word processing skills in no time!

Finding Formulary Coverage

Quite often I find myself needing to know whether a particular drug is covered on a provincial or private formularies. Usually, finding this information is not difficult, but it is time-consuming. However, I've recently found a database website that is attempting to keep track of just that.

Drugcoverage.ca is maintained by Plasmid Biocommunications, a communications company specialising in prescription drug reimbursement. As such, it isn't quite the official word on drug coverage, and their product list isn't as extensive as I would like, but the information does appear to be accurate. At the very least the website is a place to start your research.

On drugdiscovery.ca you can check to see which provinces cover a drug on their provincial formularies, and you can also check for federal coverage such as with Veterans Affairs Canada. Finally, it will give you an idea to the extent of coverage by private plans, and whether any manufacturer or other special access programs exists for the drug.

Medical Writing Survey

I received an email from a graduate student in the Biomedical Writing program at University of the Sciences in Philadelphia, who is looking for supervisors of medical writers to participate in survey she is conducting for one of her classes.

If you supervise at least 3 medical writers (including freelances), you are invited to participate in her survey.

The survey is being conducted by Jennifer Withers. You may contact her at jwithers@mail.usp.edu with any questions or comments. She is also asking for help reaching surveying participants, so please feel free to forward information about the survey to your colleagues.

AMWA-Canada Symposium Reminder

Time is running out to register for the AMWA-Canada Medical Writing Symposium taking place in Ottawa on April 18th, 2008. The deadline for registration is this Friday, March 14th.

This one-day events offers four AMWA workshops, three are accredited for the cores certificates and one is accredited for the advanced certificate. If you're enrolled in any of these programs, this is a great way to get the credits and meet up with some of your Canadian colleagues.

The event takes place at Foustanellas Auditorium of the Ottawa Heart Institute, located on the Civic Campus of the Ottawa Hospital. Workshops include:

Writing and Designing Materials for Patient Education (EW/PRAM) with Sharon
Nancekivell

Improving Comprehension: Theories and Research Findings (EW/ED) with Tom Lang

Principles of Pharmacoeconomics (EW/PH) with Christopher J. Longo

Reporting Randomized Trials in Science Journals (ADV) with Tom Lang.

Online Medical Writing Course at Concordia

For those of you who missed it this past winter session, Concordia University will be once again offering an online Medical Writing class (CE2769N/C1) next semester. The class starts April 5th and runs until June 5th. Registration is open and will continue until March 10th (next Thursday) for fax and mail enrollment, and for in-person enrollment until March 13th.

Most of this course is a basic introduction to writing for the pharmaceutical industry in Canada, including marketing (copy), CHE, and PR writing. It also takes into account the PAAB/Rx&D environment that exists in Canada but not in the USA. Actually, just about everything in this course is done within a Canadian context and it is the only course of its kind (that I'm aware of) in Canada. At the end of the course, students who have done all assignments will have at least two pieces of writing to add to their portfolios.

If you're interested in this course, time is short to register. Space is limited in the course and last semester the registration quota filled up. I believe that this course will not be offered again until 2009.

Here is a brief overview of each of the modules:

Scope and Resources: In this module we will (very) briefly review the different kinds of medical writing as well as some 'tools of the trade.' We will also explore how to find studies and information.

Pharmaceutical Industry and Marketing In Canada: In this module we will be briefly introduce you to the pharmaceutical industry in Canada. We will review the laws and industry codes that govern Canadian pharma, and will look at the relationship between health care professionals and industry.

Continuing Health Education: In this module we will be briefly introduce you to Continuing Health Education in Canada. We will review different Canadian accrediting bodies for CHE and their requirements. We will also discuss non-accredited CHE programs and take a look at the different types of CHE programs that medical writers may be called upon to create, and the role of the writer within CHE.

Advertising and Copy Writing: In this module we will take a look at pharmaceutical advertising and copy writing. We will briefly review the different types of marketing materials that medical copy writers may be called upon to write, as well as the basics of copy writing itself and the PAAB code. We will also explore how to 'translate' journal articles and clinical trial results into marketing 'copy'.

Representative Training Tools and Interactive Materials: In this section we will look at some special considerations when developing tools for sales representative training, including instructional design, learning objectives and writing evaluation questions. We will also learn how to write for web or computer-based learning environments.

Public Relations: In this very brief section we briefly look at the role of PR and media communications within the pharmaceutical industry. We will learn how to write press releases and touch on patient education material.

If you have any questions, send me a note. Also, please feel free to forward this information on to friends and colleagues who might be interested in the course.

Listening to the Journals

I love reading and writing, but sometimes my eyes need a break. That's when the word processor goes off and my media player gets turned on.

Almost since it's inception, I've been a big fan of podcasting. Originally, a podcast was a digital recording of a radio show that was then made available over the Internet for download. You could also subscribe to podcasts through a syndication feed so that your favourite show was always ready for listening. These days, it's not just radio shows that are available via podcast. Many magazines and journals create podcasts to complement their print or online content, and medical journals are at the forefront of this revolution.

Usually a podcast from a medical journal will include an overall description of what you can expect to find in the current print edition, as well as a more in-depth look at one or two of the feature stories from the issue. This may include interviews with one or more of the study authors and analysis by other leading professionals in the field.

As a medical writer, listening to podcasts is a great alternative way to stay on top of breaking medical news and discoveries, as well as current opinion. I usually include a mix of medical and science journals in my subscriptions, as well as some general interest science magazines. I listen to them while driving, making dinner, waiting for the train, or over a cup of tea in the afternoon.

Some of the podcasts that I've been enjoying recently include:

The Lancet
New England Journal of Medicine
Journal of the American Medical Association
Science
Nature
New Scientist
Scientific American
The Scientist

Some television news shows and stations have also embraced podcasting in what's now known as vodcasting, or video podcasting; but that's for another blog entry.

Medical Writing Symposium in Ottawa

AMWA-Canada has announced the 'line-up' for its medical writing symposium that will be held on April 18th at the University of Ottawa Heart Institute in Ottawa, Ontario. The symposium offers four AMWA credit workshops in two streams followed by a networking dinner. The workshops are nice cross-section of different styles and levels of medical writing. It looks like there is something for everyone. Note, that you do not need to be enrolled in the AMWA certificate programs in order to attend the workshops.

Here are the workshops on offer:

Writing and Designing Materials for Patient Education (EW/PRAM) [Course#224] Through lecture and discussion, writers with little or no experience in writing for patients will work through the “what, who, and how” of a patient education piece: planning, research, writing, design, production, and evaluation. Participants will critique sample booklets and review the homework. APPROXIMATE HOMEWORK TIME:2-3 HOURS. Workshop Leader: Sharon Nancekivell

Improving Comprehension: Theories and Research Findings (EW/ED) [Course#207] This lecture and discussion session for both experienced and novice writers will cover theories and findings from the scientific study of written communication. Applying these findings to medical writing can produce measurable differences in how well readers locate, comprehend, and use information. Participants will explore ways to apply the concepts to improve the readability of a piece of medical writing. APPROXIMATE HOMEWORK TIME: 3 HOURS. Workshop Leader: Tom Lang

Principles of Pharmacoeconomics (EW/PH) [Course#216] This workshop will introduce the principles of pharmaco-economics to medical writers unfamiliar with this field.The lecture will cover trial design, cost determination, sensitivity analysis, and research perspective in a nonmathematical manner. Groupwork will emphasize application of these principles to published materials. APPROXIMATE HOMEWORK TIME: 1-2 hours. Workshop Leader: Christopher J. Longo

Reporting Randomized Trials in Science Journals (ADV) [Course#719] This workshop is designed for experienced medical writers who want to report clinical research studies with a high degree of sophistication. The form and function of each component of the research article will be reviewed; however, emphasis will be placed on how to report all aspects of randomized controlled clinical trials. Participants will practice applying a set of detailed guidelines for reporting specific aspects of study design, research activities, and outcomes. APPROXIMATE HOMEWORK TIME: 3 HOURS. Workshop Leader: Tom Lang

For more information, visit the AMWA-Canada website

Medical Writing Programs

One of the questions that I'm frequently asked by students or via my website is, "are there any medical writing programs in Canada?" The answer, sadly, is no. Whereas a couple of Universities in the USA currently have Medical Writing programs, none exist in Canada.

The University of Toronto offers two MSc programs in Biomedical Communications, however neither focus on medical writing; they focus on medical artwork. The first program is in Biomedical Media Design. It prepares students to design and create interactive media tools. The second program, Biomedical Visual Design, is for students interested in medical illustration or producing animations of biological and physiological structures and processes. Tuition for current offerings is about $7,500.

Some post-secondary educational institutions in Canada offer stand-alone ‘science writing’ courses to students enrolled in undergraduate, graduate or post-doc science programs. For example, in Montreal, McGill University offers two courses on science writing designed to help budding scientists write better manuscripts for submission to journals. These courses appear to be open to graduate students and post-docs only, and are often not specific to medical writing.

Concordia University Continuing Education is currently the only post-secondary educational institution in Canada to offer courses in medical writing to part-time students; and no Canadian institutions are offering any kind of medical writing diploma or certificate program on a part-time basis.

Distance education through online course offerings is a welcome learning option for many professionals seeking to advance their skills or make a career change. Currently, in Canada, only Concordia University Continuing Education offers an online course in medical writing.

Professional development courses in medical and science writing are occasionally offered by groups like the American Medical Writers’ Association (AMWA) Canada, the Professional Writers’ Association of Canada (PWAC), and the Quebec Writers Federation (QWF), but these are usually few and far between and none are available online. AMWA, through it’s USA headquarters, offers a certificate program in medical writing that consists of about eight, three-hour workshops. Many Canadian AMWA members complete this program by attending chapter or national conferences. Costs for professional development offerings range from $150 for each three-hour seminar offered by AMWA as part of their certificate program, to about $200 for a 10-week series of two-hour classes offered by the QWF. Stand-alone workshops offered through PWAC or similar groups may be $10-$50 and free for members.

What Do We Do Again?

In my Internet wanderings this week for course material for an online medical writing class that I teach, I found a nice, short video interview with Susanna Dodgson, PhD, Graduate Program Director for Biomedical Writing at University of the Sciences, Philidelphia, USA. In it she describes what medical writers do. She also offers her opinion on the continuously controversial topic of ghost writing. (The interview was done by pharmedout.org, an organization that aims to counter inappropriate pharmaceutical promotion practices.)



While I don't agree with everything that she says, especially how she breaks down medical writing into only two categories and her insistence that medical writers are scientists, the interview is pretty much 'on the money'. Speaking of, she also talks about money. Our salaries in Canada aren't quite as high as in the USA, but they are close. And certainly, I do agree that medical writers are often some of the best paid writers in the communications industry.

Finding Information: Searching the Literature

After I've given myself an overview of the topic, or if it's an area I'm already familiar with, my next step is to find recent review articles, clinical practice guidelines, or possibly original research on the topic.

My search will almost always invariably start with PubMed/Medline. Other databases exist, but PubMed is by far the most accessible and serves well for most searches. You can use PubMed to search specifically for original articles, letters to the editor, clinical practice guidelines, review articles, meta-anlayses, and a whole lot more. The Pubmed website has comprehensive information about the database and how to search it. Their flash tutorials are fantastic and whether you are already familiar with PubMed searching or not, I highly recommend watching the following ones:

• PubMed Overview
• Searching Pub Med Quick Tours (5 tutorials)
• PubMed's MeSH database Quick Tours (3 tutorials)
• Getting Started with My NCBI
• Saving Searches
• Filters

Once you've located articles that look interesting, your next step is to acquire them. Some are available for free, others you may have to pay for.

The PubMed citation usually indicates if an article is available for free by putting a clickable icon on the top right-hand corner that reads something like "Free Fulltext Available." If it doesn't look like full text is available for free, click through to the journal site anyway if PubMed provides a link to it. Sometimes articles become available for free after a set period of time, and PubMed may not ahve the updated information. If it still looks like you have to pay, try going to the journal website and accessing the particulat jounral issue from there. Occasionally that yields different results than the PubMed click-through.

If you still don't get access to the journal article, you still have a few options:

• See if you can get the article through a local library
• Contact one of the authors or the press office at the institution where the article was authored to see if you can get a free copy fo the article
• Order (and pay) for the article online through the journal or its agent
• Order (and pay) for the article through a document delivery service like CISTI

Once again, Dalhousie University has an excellent online article that is worth looking at (Access to Journals) which describes ways to get your hands on actual copies of journal articles