Medical Writing Good Pharma The Light Stuff

Volume 22, Issue 4 - Good Pharma

The Light Stuff

A call to abandon the useless anachronism of the ‘define at first use’ rule for abbreviations


CTD – Common Technical Document (dossier submitted for marketing authorization)

eCTD – Electronic Common Technical Document

QC – Quality Control (process of checking consistency in documents just prior to finalization)

I was asked to give a workshop recently which involved discussing the eCTD and how this differed from a paper CTD. It occurred to me that although I haven't worked on a truly paper CTD in many years and we live and work as medical writers in what is an essentially completely electronic environment, it is astounding how many writing habits we all have which are surviving anachronistic remnants of the paper age. Although there are a number of these, today I would like to draw your attention to one of the most pointless of these which costs all of us considerable wasted time and nerves for no benefit whatever – defining abbreviations at ‘first use’.

If you think about this for even a moment, it must be obvious that this rule only makes sense if you read a document from the first page. If for whatever reason you don't start at the first page, you run the risk of missing that all-important ‘first use’ and therefore being unable to find out what an abbreviation actually means. Most competent medical writers have long since taken up the very sensible habit of including a list of abbreviations at the start of any document to ensure that no matter where you are or start reading in a document, you always know how to quickly find the meaning of any abbreviation without long and frustrating searching through the text for the ‘first use’. But despite this much more sensible alternative, most of us still spend a ridiculous amount of QC and editing time searching for and defining every abbreviation at ‘first use’.

Do we do this because we are all masochists? Actually, I believe that this is simply an old-fashioned habit that we all seem reluctant to abandon, despite its obvious lack of any utility. Here is a suggestion that could save all of us endless writing and QC time searching for a ‘first use’ which will undoubtedly change with the comments in the next review cycle. Any client or author who still asks for this should simply be directed to the list of abbreviations at the start of every document and informed that, in fact, we are still following the rule, it just so happens that ‘first use’ is the same for every abbreviation – it is the list of abbreviations!

Barry Drees





Good pharma
Message from the President
Transparency and the healthcare industry: The Sun is shining
Sunshine spreading across the Atlantic and over Europe
Bad karma
If a misinformed voice speaks out in the wilderness and no one refutes it, does it make a sound? A call to advocacy
The Big Pharma conspiracy theory
Editorial: Pharmaism
Legal remedies for medical ghostwriting: Imposing fraud liability on guest authors of ghostwritten articles
A decade of change: A new ISMPP has arrived
Selling evidence over the counter: Do community pharmacists engage with evidence-based medicine?
Good regulatory practice and the role(s) of a regulatory affairs professional
Profile: An interview with Dr Gustavo A. Silva on the concept of public health in medical writing and translation
AuthorAID: An international service and chance to serve
India as a hub for ethical and evidence-based medical communications
Providing value for medicines in older people
In the Bookstores
Journal Watch
The Webscout
Regulatory Writing
Medical Communications
Manuscript Writing
Out On Our Own
The Light Stuff


The Write Stuff Archive Contact Instructions for Authors Article Template (Word) Journal Policies

Editoral Board


Raquel Billiones


Evguenia Alechine

Jonathan Pitt

Managing Editor

Victoria White

Associate Editors

Anuradha Alahari

Jennifer Bell

Nicole Bezuidenhout

Claire Chang

Barbara Grossman

Sarah Milner

John Plant

Sampoorna Rappaz

Amy Whereat

Section Editors

Daniela Kamir


Jennifer Bell


Nicole Bezuidenhout 

Digital Communication

Somsuvro Basu

EMWA News 

Ana Sofia Correia 

Gained in Translation

Ivana Turek

Getting Your Foot in the Door

Wendy Kingdom / Amy Whereat

Good Writing Practice

Alison McIntosh 

In the Bookstores

Maria Kołtowska-Häggström

Lingua Franca and Beyond

Maddy Dyer


Lisa Chamberlain-James

Medical Communications/Writing for Patients

Payal Bhatia

Medical Devices

Evguenia Alechine

My First Medical Writing

Anuradha Alahari

News from the EMA

Adriana Rocha


Tiziana von Bruchhausen


Clare ChangZuo Yen Lee 

Regulatory Matters

Sam Hamilton

Regulatory Public Disclosure

Claire Gudex

Teaching Medical Writing

Louisa Ludwig-Begall / Sarah Kabani

The Crofter: Sustainable Communications

Louisa Marcombes

Veterinary Writing

Editors Emeritus

Elise Langdon-Neuner

Phil Leventhal

Layout Designer

Chris Monk