to the editor: I have read American Family Physician for a long time. I am basically retired and wonder if I am so far behind the times that I am the only one having trouble with all the articles that use abbreviations for words? In many articles, it becomes confusing to me, and I believe it shows only laziness on the part of the authors and editors. How many extra letters and or lines would be used to properly identify what one is saying? I would guess in all the articles combined it would add less than one fourth of a page.

Wouldn’t it be best to make sure that there is no misunderstanding by spelling out the words?

in reply: I appreciate Dr. Clague’s suggestions, and agree that clarity trumps conciseness when it comes to abbreviations. At AFP, our style is to always spell out the term on first mention, then use abbreviations when: (1) the abbreviation is in general use (for example, COPD for chronic obstructive pulmonary disease), or if it is used more frequently than the words it stands for (for example, HIV for human immunodeficiency virus, AIDS for acquired immunodeficiency syndrome, and ACTH for adrenocorticotropin hormone); or (2) when the term is used so repeatedly in the article that it would become cumbersome to spell it out at each instance (for example, CHF for congestive heart failure). In other instances, I agree with Dr. Clague that it’s best to err on the side of spelling things out (for example, we have readers for whom English is not their first language). We will be more vigilant at applying these rules, and thank Dr. Clague for keeping us on our toes.