“Why the hell is this so long? Just make your point and move on.”

The harsh commentary from my PI cut me to the bone.

After all, it was the first manuscript I assembled by myself. It was a systematic review and meta-analysis, so I reviewed the literature, compiled and analyzed data, and finally composed an epic 4,000-word paper. It was a beautiful 15-page document with “intriguing,” meandering prose.

Or so I thought.

To me, a research fellow at the time—whose only focus was researching and writing papers—this paper was a work of art. But to my audience—busy and stressed clinicians—this manuscript was a pile of unnecessary rubbish that effectively hid the research message I was trying to communicate.

As a naïve medical student, I thought the more words I said, the better I would look. I also thought the bigger, more pedantic words I used, the smarter I’d sound.

I recently finished reading Smart Brevity, written by three Axios co-founders. The book makes the case for concise communication based on marketing and consumer research.

Today's researchers and clinicians must sift through an overwhelming amount of data and unnecessary prose. And it’s only getting worse—I receive daily emails from The Journal of Atherosclerosis Research of the Left Superior Rectal Artery (or similar, oddly specific journals) asking me to review a case report.

Beyond an increasing volume of research that doesn't contribute meaningful data to the literature, many scientific papers—even meaningful studies— are filled with fluff. Conciseness is critical for time-crunched healthcare professionals who must sift through oceans of data to find the best way to care for their patients.

I’m undoubtedly guilty of contributing to the problem—I’ve stuffed manuscripts to the brim with complex filler words trying to make my authorship and I sound “smart.”

Therefore, the idea of smart brevity is incredibly relevant to science writing. Here, I want to discuss a few important points I’ve learned from Smart Brevity and how they can be applied to science writing.

1. Be Selfless.

Write for the audience.

Some how-to writing books emphasize that writers should write for themselves, be themselves, say what they want, and not worry about the audience. Authors commonly ask themselves before writing: What do I want to say? 

But for science writing, a more relevant question is: What does my audience want to hear? I have learned that this is the key to crafting engaging content that keeps an audience focused.

Today’s clinicians are increasingly stretched. To make things worse, there is an absurd amount of new research, drugs, devices, guidelines, and indications that require study. This means the way information is presented to them—be it a scientific paper or CME activity—needs to convey a main point accurately and concisely. The scientific author needs to keep this in mind.

Another method of achieving selflessness is by considering what your audience likely already knows. For example, a study evaluating the efficacy of a new immune checkpoint inhibitor for lung cancer doesn’t need a five-paragraph introduction discussing the commonness of lung cancer—the audience of oncologists already knows this.

So, write for the learner.

2. Simplicity is Key

Keep it simple.

I cringe when I read my older writing. I remember writing an introduction section for my college research thesis, and, at that time, I thought that more verbose, complex, and long sentences correlated with "smarter" authoring.

The professor who graded my first draft thought otherwise, for good reason.

Strunk and White’s classic Elements of Style repeatedly emphasize the importance of clear, simplistic writing. This principle applies to all scientific writing, from slide decks for a CME activity to the modules of the Common Technical Document. Busy and stressed clinicians (or FDA employees) will disengage if they cannot comprehend what they read. Sentences with too many adverbs or unnecessarily complex scientific jargon will quickly lose an audience. 

In the opening sentence of a discussion section, instead of saying:

It can be appropriately inferred from the statistical analysis of the present retrospective systematic review and meta-analytic data that those pancreatic oncological study participants who were not treated with the aforementioned chemotherapeutic regimen were statistically significantly more likely to manifest a higher mortality rate as compared to such patients who were treated with this combination drug therapy,

Say:

Our review suggests that FOLFIRINOX offers a survival benefit to patients with pancreatic cancer.

Shamefully, a lot of my writing has sounded more like the former. I thought it made me sound smart, but I’ve learned to appreciate how beautiful simplicity is.

3. Grab the Audience

What is the most essential message? What is the communicator's main point? Make it quick to pull the consumer into the article or activity.

Some studies suggest that online readers spend, on average, 26 seconds reading an article they want to read, and only 20% of readers make it past the first page. These numbers are certainly smaller for learners consuming information out of obligation—such as a nurse completing a CE course who needs to keep his license active. This offers a minuscule amount of time to pull the learner in and get your point across. In science writing, this emphasizes the need to get the main point—or learning objective—across quickly so the audience isn’t lost.

Anyone who has written a review paper knows how annoying it can be when this rule is not followed: Digesting multiple paragraphs of irrelevant content before finding the information we seek is tedious and inefficient. Many scientific papers do an excellent job of burying their main points deep within an avalanche of prose, quickly losing the learner’s interest.

Scientific manuscripts can exemplify this principle well. When I quickly learn the study's primary purpose, I’m much more likely to keep reading through the paper in its entirety. In contrast, reading four paragraphs of irrelevant meandering has the opposite effect. Likewise, I’m much more likely to read about the implications of a study in the discussion section when I know from the first couple of sentences what the main finding is.

Similar cases can be made for CME/CE content. This is why crafting clear and concise learning objectives before an activity is essential: It immediately lets a group of busy, distracted clinicians know precisely what they will be learning and the activity's goals, making it more likely to engage them.

4. Be Human

Don’t use big, pompous words. Instead, use language that would be used when talking to a friend over coffee. Anglo-Saxon words usually consist of one syllable and are easily understood compared to their Latinate counterparts (mark vs. designate, small vs. diminutive, or start vs. commence).

Again, I’m guilty of overly complex wording in my writing.

In scientific writing, sometimes, this is unavoidable. We need to use words like multivariate regression analysis and epithelioid hemangiopericytoma. But just because we are using medical jargon doesn’t mean that other areas of the paper need to contain equally complex words where a simpler word can be used.

Again, I will cite Elements of Style, as well as On Writing Well by William Zinsser. Simple, clear writing is effective writing. Large, complex words can be unnecessarily confusing and make the author seem arrogant.

Instead of commencing a therapeutic regimen, start treatment. Does the patient need an immediate invasive neurological intervention? Or do they need emergency neurosurgery?

We sometimes need to use big, disgusting scientific words in science writing. So, ensuring the rest of our writing is more “human” is essential. I can’t recall when I’ve used a word like “consequentially” in everyday conversation, but perhaps my vocabulary isn’t very innovatory.

5. Stop Writing

The goal of any paper, document, or presentation should be to get the main point across using as few words as possible. Papers or presentations with a clear, well-defined point can easily do this. Those that don’t have a clear objective are often muddled, meandering, and lengthy.

Anyone who has sought specific information from the literature is probably familiar with the challenge of dealing with unnecessarily long papers, which may include:

• Six paragraph-long introductions that ramble about the epidemiology of Parkinson’s disease while waiting until the last two sentences of the final paragraph to state that their study aims to evaluate the safety of a new neuromodulation device.
• Exhaustive methods sections that use complex verbs, adverbs, and nouns to describe, in specific detail, every step of a surgical procedure.
• Discussion sections that begin with three paragraphs recounting the history of beta blockers for heart failure when the study focused on testing the efficacy of a new inotropic agent.
• And so on.

Each paper, slide deck, and regulatory document has a specific objective. Once the study's results and meaning have been concisely described or a particular learning objective achieved, the rest of the included material only contributes to the ever-growing swamp of words in the literature.

This point also relates nicely to the first and third points: The audience will appreciate it.

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After reading Smart Brevity, my mindset regarding effective communication has shifted. Like many, I have long believed that the more you say, the smarter you sound. In Elements of Style, E.B. White notes that the more time one spends in school, the murkier and unnecessarily complex one's writing becomes. However, wordy, lengthy, and complex writing is an ineffective, selfish attempt to emphasize the writer instead of the message.

I’ve noticed that AMWA recently adopted “lean authoring,” a very similar concept to smart brevity, as one of its competencies for regulatory writers. This makes sense when composing regulatory documents for the FDA or other regulatory bodies. However, this concept and smart brevity can be applied to all aspects of scientific writing.

To conclude, I will say that it is ironic that this post on Smart Brevity is on the longer side.