Unfortunately, native English speakers frequently write complicated and confusing prose too, either because they ignore the rules of grammar or because they ignore the concept of expected place/order, which means the following:
≫When you read something and try to understand it, you instinctively look for different types of information in specific parts of a sentence or in a specific order.
Therefore, if we want to write clear English that reviewers and other researchers can understand easily, we should put each piece of information in its expected place. Research on this subject has demonstrated that arranging information in the order that your audience expects will improve the level of understanding of the readers. We would instinctively expect that this is so, but it is nice to have it confirmed. This concept also applies to the arrangement of information in the Tables and Figures of a manuscript.
For example, we know that the basic arrangement of an English sentence is subject/verb/object, so readers instinctively expect the verb that applies to a subject to be positioned near it in a sentence and for the object to follow soon after the verb, but this may not happen in a complex sentence. Some of the research I mentioned above has shown that the risk of misunderstanding a sentence increases as the number of words interposed between each of these main elements becomes larger.
Consider the sentence: “Drug X was administered to 125 patients with hypercholesterolemia for 6 months.”
There is no difficulty understanding this, or is there? Does it mean:
a) 125 hypercholesterolemic patients were treated with drug X for 6 months
b) 125 patients with hypercholesterolemia for 6 months were given drug X
c) Both of the above
Please select the option that you think is correct.
The answer is c), although the intended meaning was most likely a) if the sentence was written by a native speaker. We can avoid ambiguity as follows:
a) "Drug X was administered for 6 months to 125 patients with hypercholesterolemia."
By putting the modifying information directly after the verb, we remove the chance for the reader to associate it with hypercholesterolemia.
b) "Drug X was administered to 125 patients with hypercholesterolemia that had not responded to dieting for 6 months."
By adding some more information, ambiguity is removed.
Now, let’s try at a harder example. Look at the data in Table 1. Then read the sample sentence on the next page and answer the questions. (For the questions in the rest of this handout, please cover the printed answers until you have made your choice or written your answer in the space provided.)
a) Sample sentence for Table 1:
"In a multicenter double‐blind trial of drug X, a strong statin, this drug was administered for the treatment of hypercholesterolemia in 125 ambulatory patients, including 80 men and 45 women with a mean age of 67 years, mean BMI of 27.8 kg/m2, and serum cholesterol levels
> 140 mg/dl who had not been treated with statins before, who had failed to respond to diet and exercise and were attending any of 3 participating hospitals in central Japan, for 6 months."
My answers are as follows (you may not agree with them):
(partly), (too much), (not good), (sort of)
I chose (sort of) instead of (no) for the last answer because some things are in the expected place. In fact, it starts out okay, but tries to convey too much information and becomes confusing, so let’s improve it.
b) Revising the sample sentence:
“In a multicenter double‐blind trial, drug X (a strong statin) was administered for the treatment of hypercholesterolemia to 125 outpatients of 3 participating hospitals in central Japan, including 80 men and 45 women with a mean age of 67 years and mean BMI of 27.8 kg/m2. All subjects had serum cholesterol levels > 140 mg/dl, had not been treated with statins before, had failed to respond to diet and exercise, and had been attending any of 3 participating hospitals in central Japan for 6 months.”
For this example, the sentence has been rewritten to mean what most readers would expect when they read it (the others would just be confused).
c) Revised version:
“In a multicenter double‐blind trial, drug X (a strong statin) was administered for the treatment of hypercholesterolemia to 125 outpatients, including 80 men and 45 women with a mean age of 67 years and mean BMI of 27.8 kg/m2. All subjects had serum cholesterol levels > 140 mg/dl, had not been treated with statins before, had failed to respond to diet and exercise, and had been attending any of 3 participating hospitals in central Japan for 6 months.”
Reorganising some data and breaking it up into 2 sentences makes the information much easier to read. But can you see what else has happened? You have access to background data, so please compare the revised text with the information in Table 1.
Why does the average reader connect ‘for 6 months’ to ‘hospitals’ rather than to ‘drug X’? Is it because of (lack of scientific knowledge) or the influence of (the expected place)?
The answer is (the expected place), because a native English speaker expects related parts of a sentence to be close to each other in the sentence, not far apart. So the average reader just deletes a comma and the sentence then makes perfect sense to him/her. If the reader then looks at Table 1, he/she will become confused and not know what to think. Therefore, it is really important to keep this concept of the expected place in mind when writing English. (Otherwise, you are going to need a very experienced editor who checks the text against the other data and knows the tricks of Japanese authors /translators.)