Research Viewpoints

A Word is Worth 1000 Words

When writing for an audience of your peers or a non-specialised audience, how you write matters as much as what you write. Communicating your message with integrity is a way to enhance trust in your publication and ensure that you are conveying your message effectively and respectfully. In this series on Communicating with Integrity, we discuss some of the key factors to incorporate when preparing your manuscript.

Previously, we have discussed how trust can be built through transparency, and how to ensure we maintain trust when communicating with a non-specialised audience.  In this article, we discuss why word choice matters. Terminology matters for the reproducibility of your research, as well as for any communities you are referring to in your writing. Failure to write with integrity can have unintended consequences on how your research is received and interpreted.

The following is based on the recommendations from the Coalition for Diversity & Inclusion in Scholarly Communication (C4DISC) Guidelines on Inclusive Language and Images in Scholarly Communication [1], which Karger recommends referring to when preparing a manuscript.

Be specific about who is involved in the study.

When reporting demographic variables, consider whether these variables are relevant to the study. If an individual’s race, gender identity or sexual orientation is not relevant to the study, consider whether these demographics should be included at all.

Where it is relevant to include demographic information, be specific. The use of ambiguous or general terms when describing individuals can reduce the reproducibility of research and may offend the people involved. It is important to be specific about the population you are describing, for example, do not say ‘Central American people’ if you mean “Mexican men”.

If people have not been given the opportunity to self-describe their gender identity, race or ethnicity, such demographics should not be assumed from the sex assigned at birth or nationality. Asking people to self-describe the terms they use is the most accurate and specific way to capture relevant information.

Use inclusive language when describing individuals.

Inclusive language should communicate to and about people with respect. Language is constantly evolving, and once commonplace terms may now offend. As above, when referring to a specific population be specific about who the population is and use appropriate terms, for example, “70-80 years old people” is preferable to “older people” which itself is preferable to “the elderly.”

In referring to a specific population, give priority to community-adopted terms and where possible, allow people to self-describe and use that term in your manuscript. When describing health conditions, look to the community for the preferred terminology whether this is identity-first or person-first terminology. For example, “person with cancer” or “person with obesity” is preferable to “cancer patient” or “obese person,” however, “autistic person” is generally considered preferable to “person with autism.” What we say matters as much as how we say it. How you communicate can contribute to reinforcing or dismantling stigma, discrimination or Eurocentrism. The above is a very short overview of just some of the key concepts, and we would recommend the resources available below for more information.

Resources

1. Introduction. In: Guidelines on Inclusive Language and Images in Scholarly Communication [Internet]. Coalition for Diversity and Inclusion in Scholarly Communications; 2022. Available from: https://c4disc.pubpub.org/pub/8olmuvdm (Accessed 8/1/2025)
2. https://www.england.nhs.uk/learning-disabilities/about/get-involved/involving-people/making-information-and-the-words-we-use-accessible/ (Accessed 8/1/2025)
3. Weghuber, D., et al., (2023), Championing the use of people-first language in childhood overweight and obesity to address weight bias and stigma: A joint statement from the European-Childhood-Obesity-Group (ECOG), the European-Coalition-for-People-Living-with-Obesity (ECPO), the International-Paediatric-Association (IPA), Obesity-Canada, the European-Association-for-the-Study-of-Obesity Childhood-Obesity-Task-Force (EASO-COTF), Obesity Action Coalition (OAC), The Obesity Society (TOS) and the World-Obesity-Federation (WOF). Pediatric Obesity, 18: e13024. https://doi.org/10.1111/ijpo.13024
4. Heidari, S., Babor, T.F., De Castro, P. et al. Sex and Gender Equity in Research: rationale for the SAGER guidelines and recommended use. Res Integr Peer Rev 1, 2 (2016). https://doi.org/10.1186/s41073-016-0007-6

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Saying What You Mean and Meaning What You Say

When writing for an audience of your peers or a non- specialised audience, how you write matters as much as what you write. Communicating your message with integrity is a way to enhance trust in your publication and ensure that you are conveying your message effectively and respectfully.

In this series on Communicating with Integrity, we are discussing some of the key factors to incorporate when preparing your manuscript. You can read part one, Laying a Foundation for Trust.

In this article, we consider how what is not said can impact trust in a publication, particularly when communicating with a non-specialised audience, be it patients, policymakers or the general public.

Be specific about the level of certainty of any claims, using numerical rather than verbal expressions.

Readers can interpret verbal indicators of uncertainty differently, e.g. “It is likely that X is a cause of Y” can imply to a reader near certainty or only moderate certainty in a relationship. This is particularly relevant when you are communicating to a non-specialised audience.

Communicating numerically reduces the risk of misinterpretation, e.g. it is better to say that “X is estimated to cause more than 50% of the cases of Y in Switzerland.”.

When expressing risk as fold change, e.g. “7 times more likely”, the expression should be accompanied by the actual risk scores and range of confidence intervals.

Acknowledge sources of uncertainty.

In all research publications, it is important to include a limitations section in which factors that may impact the generalisability or certainty of the findings are described. This should be transferred to any secondary publications, whether this is a systematic review or a blog post about the research. Communicating limitations or uncertainty is an important part of protecting against loss of trust if evidence changes [1].

Important potentially limiting factors to translate to a publication include:

• Distinct population (was the study conducted in a specific environment or with a demographic group that may limit generalisability?)
• Sample size (was the study small or large and did it control for relevant independent variables),
• Effect size (just because a result is statistically significant does not mean that it is meaningful, is the effect size described?)
• Level of evidence (are discussed studies only in animal models or case reports?)

Do not make any unsubstantiated claims or fallacies.

An author may believe that their study conclusively proves their hypothesis. However, it can be easy in these circumstances to commit a logical fallacy because of the certainty of the conclusion. E.g. “Smoking is the main cause of lung cancer in the UK. Jan has lung cancer. Therefore, Jan’s smoking must have caused their lung cancer.”.

Everyone is vulnerable to making such errors and so, as an author and a reader, you should be critical when reading your own or others’ work for such fallacies or overstated conclusions.

References

1. Dries, C., McDowell, M., Rebitschek, F. G., & Leuker, C. (2024). When evidence changes: Communicating uncertainty protects against a loss of trust. Public Understanding of Science, 33(6), 777-794. https://doi.org/10.1177/09636625241228449

Further reading

Morgan et al., ‘Communicating with integrity – Supporting researchers with best practice in communication’ League of European Research Universities. Online:

https://www.leru.org/publications/communicating-with-integrity-supporting-researchers-with-best-practice-in-communication (Accessed 8/1/25)

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Laying a Foundation for Trust

When writing articles for your peers or a non-specialised audience, communicating your message with integrity is fundamental to maintaining trust in your publication. In this series on Communicating with Integrity, we discuss some of the key factors to incorporate when preparing your manuscript for publication to ensure that you are conveying your message effectively and respectfully.

In this first article, we consider some of the fundamental elements of a paper and how trust can be built through transparency.

Include a comprehensive and representative summary of the literature.

The foundation of trust in your research starts from the literature review. The literature included in your paper should be comprehensive and up to date to capture the current state of knowledge of the field. It is usually more appropriate to cite original research articles, however, citation of a comprehensive review article may be appropriate, depending on the context. It is also important to present an accurate representation of the literature, and this may mean the inclusion of studies that do not support your hypothesis or results.

Your work should present a critical assessment of the literature. Citing a range of sources, including competing or opposing work where applicable, can help strengthen the rationale for your study whilst demonstrating that you are conducting your research with a focus on rigour. Deliberate misrepresentation or biased presentation of the literature, aimed at providing support for your conclusions while neglecting conflicting opinions or data, must be avoided.

Declare any potential conflict of interest.

All relationships that could be perceived as a potential conflict of interest must be declared, in accordance with our Editorial policies, even if you do not think the relationship is relevant. As the ICMJE describe:

“Individuals may disagree on whether an author’s relationships or activities represent conflicts. Although the presence of a relationship or activity does not always indicate a problematic influence on a paper’s content, perceptions of conflict may erode trust in science as much as actual conflicts of interest. Ultimately, readers must be able to make their own judgments regarding whether an author’s relationships and activities are pertinent to a paper’s content”

Err on the side of transparency and disclose any relationships that a reader may find relevant to the work.

Detail changes from the original protocol.

Despite your best efforts, reality can get in the way of the best-designed research plans and being transparent about adaptions to planned protocols can help enhance trust in your work. Studies rarely follow a linear path and being open about how projects have been adapted in response to changes in circumstance or new data may in fact enhance the impact of your overall results. On the other hand, failure to explain why a study description differs from a published study protocol can undermine a reader’s trust in the study and may result in a rejection decision. Be straightforward about necessary modifications to the study design and explain how this may or may not impact the generalisability or certainty of the findings.

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