‘Use the active voice whenever possible’: The Impact of Style Guidelines in Medical Journals

Abstract

Medical writing is sometimes criticized for excessive use of the passive voice. The purpose of this study is twofold: (i) to provide quantitative descriptions of how the passive voice is used in medical journals and (ii) to assess the impact of style guidelines encouraging use of the active voice. From a corpus of 297 primary research articles published in the top five medical journals, we extracted 19,691 passive constructions. Analyses show that guidelines have a significant effect on use of the passive voice, and that this is highly localized in the ‘Methods’ and ‘Results’ sections. Analyses also identify a core set of verbs which are strongly associated with the passive voice, and which play a central role in structuring the discourse. We argue that current guidelines influence author’s linguistic choices, and that although paraphrasing a sentence in the active voice may be possible, a passive alternative is sometimes preferable. Findings demonstrate the need for formative guidelines which better reflect the reality of conventionalized usage.