J-2_Style_Guide.docx

Attachment J-2 Style Guide for the ESRD Network Program

Table of Contents

I. Overview

This Attachment provides guidance to the Network on writing for internal and external audiences.

These guidelines are not intended to be a definitive or exhaustive source on grammar or writing style. Language is always changing, and often there is no single “correct” answer to a spelling, punctuation, grammar, or usage question.

The purpose of this style guide is to ensure consistency in written communications across the ESRD Network Program.

II. Writing about CMS, the ESRD Networks, and the ESRD Network Program

All guidance in Section II is required.

II.A. Centers for Medicare & Medicaid Services (CMS)

The full name of the agency includes an ampersand (&), not the word “and.” The abbreviation is “CMS.”

Use “CMS,” not “the CMS,” as the subject of a sentence.

The full agency name and the abbreviation both take singular verbs.

Examples:

The Centers for Medicare & Medicaid Services (CMS) is a federal agency.

CMS is a federal agency.

The possessive forms of the agency name and abbreviation are “Centers for Medicare & Medicaid Services’” and “CMS’.”

Examples:

The Centers for Medicare & Medicaid Services’ (CMS’) commitment to quality improvement CMS’ commitment to quality improvement

II.B. End Stage Renal Disease Network Organizations (ESRD Networks)

Do not capitalize “end stage renal disease” except at the beginning of a sentence or as part of a name or title. Do not hyphenate “end stage” except as part of a name or title.

The abbreviation for “end stage renal disease” is “ESRD.”

In materials for health professionals, patients, and/or the public, do not use the term “End Stage Renal Disease Network Organization.” Use “End Stage Renal Disease Network (ESRD Network)” on first mention. Use “ESRD Network” or “Network” on subsequent mentions.

In materials for health professionals, patients, and/or the public, do not use the abbreviation “NW.”

Always capitalize “ESRD Network.” Always capitalize the word “Network” when it refers to an ESRD Network.

Use “Network 1,” “Network 2,” etc., instead of “Network #1,” “Network #2,” etc.

Use “it” and “its,” not “they” or “their,” when referring to a single ESRD Network.

Example:

· The Network communicates regularly with stakeholders in its jurisdiction.

Do not refer to providers as "in the Network." Providers are located in the geographic area covered by the Network, which can be described as “the Network area,” “the Network's jurisdiction,” “the Network's service area,” or an analogous description.

Examples:

The Network works closely with providers in its jurisdiction.

The Network sends regular fax blasts to providers in the Network area.

Do not say that the ESRD Network Program covers all U.S. states and territories. Washington, DC, is not a territory, and there are some small Pacific territories that aren't explicitly covered by the ESRD Network Program.

II.C. End Stage Renal Disease Network Program (ESRD Network Program)

Do not refer to the ESRD Network Program as “the ESRD program,” “the Medicare ESRD program,” or “Medicare’s ESRD program.”

Medicare’s ESRD program is a federal health insurance program for individuals who need dialysis or transplantation to sustain life.

The ESRD Network Program is the Medicare quality improvement program for individuals with ESRD, regardless of whether they are enrolled in Medicare.

III. Quick Reference Guide: Spelling, Capitalization, and Punctuation

All guidance in Section III is required, except as otherwise noted.

Abbreviations are shown in parentheses. Semicolons are used to separate acceptable alternatives.

III.A. Required Spelling, Capitalization, and Abbreviations: Agencies, Organizations, Components of Agencies/Organizations

Central Office; CMS Central Office Center for Clinical Standards and Quality (CCSQ) Centers for Disease Control and Prevention (CDC) Centers for Disease Control and Prevention’s (CDC’s) Centers for Medicare & Medicaid Services (CMS) Centers for Medicare & Medicaid Services’ (CMS’) Critical Access Hospital (CAH) Department of Health and Human Services (DHHS or HHS) Government Accountability Office (GAO) Medicare Advantage organization (MA organization) National Institutes of Health (NIH) Office of Inspector General (OIG) Office of Management and Budget (OMB) Prospective Payment System hospital (PPS hospital) Regional Office (RO); CMS Regional Office Social Security Administration (SSA) State Survey Agency (SA) The Joint Commission (TJC) U.S. Census Bureau

III.B. Required Spelling, Capitalization, and Abbreviations: Programs, Projects, Initiatives, Legislation

Census; U.S. Census Conditions for Coverage for End-Stage Renal Disease Renal Disease Facilities (ESRD CfCs) [Note use of hyphen in “End-Stage”] Consumer Assessment of Healthcare Providers and Systems In-Center Hemodialysis Survey (ICH CAHPS) CROWNWeb (CW) Dialysis Facility Compare (DFC) Health Insurance Portability and Accountability Act of 1996 (HIPAA) Learning and Action Network (LAN) Medicare Part A (Part A) Medicare Part B (Part B) Medicare Part D (Part D); Medicare prescription drug coverage National Healthcare Safety Network (NHSN) National Kidney Foundation Kidney Disease Outcomes Quality Initiative (NKF KDOQI) QualityNet; QualNet; QNet Special Project

III.C. Required Spelling, Capitalization, and Abbreviations: Commonly Used Terms angiotensin receptor blocker bachelor’s degree chronic kidney disease (CKD) CMS Certification Number (CCN) continuous quality improvement (CQI) Contracting Officer’s Representative (COR) Contracting Officer’s Representatives (CORs) database Daylight Saving Time (DST) Diagnosis-Related Group (DRG) Diagnosis-Related Groups (DRGs) electronic health record (EHR) electronic medical record (EMR) failure to place (F2P) fax fee-for-service Medicare (FFS Medicare); Original Medicare; traditional Medicare fee-for-service Medicare beneficiaries; fee-for-service Medicare enrollees follow up [verb] follow-up [noun and adjective] Frequently Asked Questions (FAQs) full-time-equivalent employee (FTE) Government Task Leader (GTL) hardware Health Insurance Claim Number (HICN) healthcare-acquired infection (HAI) healthcare-acquired infections (HAIs) home health agency (HHA) information technology (IT) internal quality control (IQC) International Classification of Diseases, 10th Revision (ICD-10) International Classification of Diseases, Ninth Revision (ICD-9) International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) Internet intranet involuntary discharge (IVD) involuntary discharges (IVDs) involuntary transfer (IVT) involuntary transfers (IVTs) listserv low-income master’s degree Medicare Advantage plan (MA plan) Medicare beneficiaries; Medicare enrollees; people with Medicare Medicare managed care plan Medicare-underserved population groups Medicare-underserved racial/ethnic population groups Memoranda of Agreement (MOAs) Memorandum of Agreement (MOA) Metropolitan Statistical Area (MSA) National Provider Identifier (NPI) national-level nationwide New York City New York State; state of New York non-English-speaking non-peer-reviewed nonprofit not-for-profit nursing home (NH) statewide teleconference Unique Physician Identification Number (UPIN); see also Physician Identification Number and Provider Identification Number update [noun and verb] up-to-date value-driven health care voicemail Washington, DC (DC); District of Columbia Washington; Washington State; state of Washington Web; World Wide Web WebEx website Web page ZIP Code

III.D. Recommended Spelling, Capitalization, and Abbreviations: Commonly Used Terms

Note: These are recommendations, not requirements.

a.m.

audiovisual decision maker decision-making DO [for Doctor of Osteopathy] health care [noun] healthcare [adjective] long term care (LTC)

MD

multicultural nurse practitioner (NP) online on-site p.m.

payers PhD physician’s assistant (PA) post-test pre-existing pre-test registered nurse (RN) timeframe U.S.

worksite x-ray

IV. Style Issues By Topic

All guidance in Section IV is required.

IV.A. Abbreviations and Acronyms

When an abbreviation or acronym is more familiar than the full name of an organization/agency, the abbreviation or acronym can be used instead of the full name.

In general, use the full name of an organization or agency on first mention, followed by any abbreviation or acronym in parentheses. The abbreviation or acronym can be omitted at the writer’s discretion if an organization or agency is mentioned only two or three times in the document.

Once an abbreviation or acronym has been introduced, use it in all subsequent mentions. Exception: A shortened version of the full name can be used interchangeably with the abbreviation or acronym.

When using a shortened version of the full name, capitalize words such as Agency, Board, Committee, or Panel only when they are part of the entity’s full name.

Examples:

the Board [for: Medical Review Board] the agency [for: Centers for Medicare & Medicaid Services]

IV.B. Ampersand

Do not use an ampersand (&) except as part of a name or title.

IV.C. Dates

In narrative text, always spell out the names of months.

Never use 1st, 2nd, 3rd, etc., for days of a month.

Example:

· The conference will be held on April 3.

Use commas to set off a year that follows a specific date, but do not insert a comma between a month and year.

Examples:

The meetings are scheduled for October 6, 2015, and April 4, 2016.

The October 2015 meeting will be held in Baltimore.

In date ranges, use an en dash (see Section VI), from/to, or from/through. Do not use “from” without “to” or “through.” Do not use “between” because it is inexact; for example, “between January and July” could refer to January through July or, more logically, February through June.

Examples:

Incorrect: from 1991–1994 Correct: in 1991–1994 Correct: the four-year period 1991–1994 Incorrect: between 1991 and 1994 Correct: from 1991 to 1994 Correct: from October 1, 2008, through September 30, 2009

IV.D. Directions / Regions

Directions (north, south, east, and west) should only be capitalized when part of the name of a specific geographic area.

Examples:

· East Coast

· the South

· travel south for the winter

IV.E. Diseases

Do not capitalize the name of a disease unless the disease is named after an individual.

Examples:

· chronic kidney disease

· diabetes

· Down syndrome

· end stage renal disease

IV.F. Job Titles

Do not use “physician” and “MD” interchangeably. The term “physician” can refer to a doctor of medicine (MD), a doctor of osteopathy (DO), or another licensed medical practitioner.

Always capitalize “Contracting Officer’s Representative,” “Government Task Leader,” and other CMS titles.

IV.G. Lists

Use bullet lists except when the items in a list are in sequential order. Use a numbered list for sequential items.

The items in a bulleted or numbered list must be grammatically equivalent. For example, if any item in the list is a full sentence, then every item in the list must be a full sentence.

If the items in a bulleted or numbered list are complete sentences:

Capitalize the first word in each item.

Use a closing punctuation mark (period, question mark, or exclamation point) at the end of each item.

Do not use the word “below” to refer to a list that immediately follows. “Below” implies much later on in the document.

IV.H. Money

Always use the word cent; never use the cent symbol.

Use the dollar sign ($) for all dollar amounts. Never use the word “dollar” with the dollar sign.

Examples:

$3.25 $3 million $3.25 million

IV.I. Names, Academic Degrees, and Credentials

When giving a person’s name and academic degrees/credentials:

Do not use Dr., Mr., Ms., etc., on first mention.

On first mention, give the full name followed by a comma and then the degree(s)/credential(s).

Separate degrees/credentials with commas. Within a sentence, insert a comma after the final credential.

List the highest academic degree first, followed by other degrees, professional designations, and certifications.

Do not list bachelor’s degrees. Exception: For a registered nurse with a bachelor’s degree, list “RN” first followed by the bachelor’s degree.

Do not list a master’s degree for an individual who has a PhD, ScD, or comparable degree in the same field as the master’s degree.

After the first mention, use the individual’s title and last name.

Examples:

John Snow, MD, MPH Ida Wells, PhD, has joined our staff. Dr. Wells is an experienced health services researcher.

IV.J. Newspapers, Magazines, and Journals

Italicize the names of newspapers, magazines, and journals and their abbreviations.

Italicize “the” when it is part of the formal name of a publication.

Examples:

The Washington Post The New York Times Time magazine The New England Journal of Medicine the New England Journal

IV.K. Numbers

Spell out numbers one through nine, except as otherwise noted in this section. Use numerals for 10 through 999,999, except at the beginning of a sentence.

Use the words million, billion, trillion, etc., for large numbers.

Examples:

a million one million

1.2 billion

Use numerals:

for ages, except “one-year-olds” and “one-month-olds” for dates for measurements for dosages with a.m. and p.m.

with o’clock in mathematical formulas, statistical data, tables, charts, and graphics.

Spell out “first” through “ninth.”

Spell out “twofold” through “ninefold.” Hyphenate “10-fold,” etc.

Spell out numbers at the beginning of sentences.

Example:

Twenty-one facilities met their target.

When possible, rewrite sentences so they don’t begin with numbers.

When a number from one to nine and a number greater than nine appear in the same sentence or paragraph, bend the rules as necessary for ease of reading, especially when making a direct comparison between two numbers.

Examples:

The doctor saw two of the ten patients.

The doctor saw 2 of the 10 patients.

Use commas in numbers of four or more digits.

Examples:

1,234 12,345 123,456 1,234,567

Use the word “zero” in narrative text. Use “0” in mathematical formulas, statistical data, tables, charts, and graphics.

Use a zero before the decimal point for values less than one.

Examples:

0.015 0.15

IV.L. Percentages

Distinguish between percent increases (or decreases) and percentage point increases (or decreases). For example, an increase from 20 percent to 30 percent is both a 50 percent increase and a 10 percentage point increase.

Always spell out “one percentage point.” Use numerals for higher percentage points.

Examples:

3 percentage points 15 percentage points

In mathematical formulas, tables, charts, and graphics, use the percent sign for all percentages.

Examples:

mean = 1% (range 0.75% to 2.1%) mean = 11.2% (range 12.4% to 16.5%)

In narrative text, use numerals and the percent sign for all percentages other than “one percent.” In general, use “one percent” in narrative text; however, “1%” can be used for consistency when it appears in close proximity to other percentages.

Examples:

Only one percent of eligible respondents failed to complete the questionnaire.

Only 1% of potential female respondents and 3% of eligible male respondents failed to complete the questionnaire.

IV.M. State and Federal Government

Do not capitalize “federal,” “government,” “state,” or “national,” except at the beginning of a sentence or as part of a name or title.

Spell out state names in narrative text, except in addresses that include ZIP Codes. In addresses with ZIP Codes, use the two-letter Postal Service abbreviations for state names.

Use commas to set off a state name or state abbreviation that follows the name of a city or town. However, do not use a comma between a state address and the ZIP Code.

Examples:

The Portland, Maine, site is closed for renovations.

The latest report, titled “Medicare Enrollment in Portland, Oregon, 2014–2015,” is now available.

My mailing address is P.O. Box 555, Beaumont, TX 77777.

IV.N. Telephone Numbers

Except for 1-800-MEDICARE, give telephone numbers as follows:

410-555-1234 800-555-1234

For extensions, use an “x” or the abbreviation “ext.”

Examples:

I can be reached at 410-555-1000 x 123, or 800-555-0123.

I can be reached at 410-555-1000, ext. 123, or 800-555-0123.

IV.O. Time

In material for health professionals, patients, and/or the public, use noon and midnight, not 12 p.m. or 12 a.m. As appropriate, specify the time zone.

Use the en dash (–) to connect time spans. (See Section VI for more information on en dashes.)

Examples:

She arrived at 8 a.m. and hopes to leave at 4:30 p.m.

The seminar runs from 8 a.m. to noon.

Will you attend the 8 a.m.–11:30 a.m. session or the 1 p.m.–5 p.m. session?

IV.P. Titles of Articles and Other Published Material

Use the following capitalization rules for titles of articles, books, reports, manuals, and Web documents:

Capitalize the first and last words in the title.

Capitalize nouns, pronouns, adjectives, and adverbs.

Lower case all prepositions.

Lower case the word “to” in infinitives except when the first or last word in a title.

Lower case the coordinating conjunctions “and,” “but,” “or,” “for,” “nor.”

Capitalize subordinating conjunctions such as “if,” “because,” “as,” “that.”

Capitalize each element of a hyphenated compound.

Examples:

The article is titled “Low-Risk Procedures.”

See the latest “State-Level Data Update.”

Enclose titles of articles in quotation marks.

Example:

“Flu Season Begins” is the lead story in today’s paper.

Italicize titles of books, reports, manuals, and Web documents. See below for capitalization rules.

Examples:

The title is Curing Health Care: New Strategies for Quality Improvement.

Details can be found in the 2012 National Healthcare Disparities Report.

V. Commonly Confused Terms

All guidance in Section V is required.

assist / help Never use “assist” without “in” or “with.” For example, instead of “assist to,” use “help to,” “assist in,” or “assist with.”

Incorrect: We can assist you find solutions.

Incorrect: We can assist you finding solutions.

Awkward: We can assist you to find solutions.

Acceptable: We can assist you with finding solutions.

Acceptable: We can assist you in finding solutions.

Best: We can help you find solutions.

bimonthly “Bimonthly” has two meanings: twice a month and every other month. In place of “bimonthly,” use “twice a month,” “twice monthly,” or “every other month.”

case / patient A case is an instance or episode of a disease or other condition. A case is not a person and does not have qualities such as age or sex. To refer to an individual, use a descriptive term such as “ESRD patient,” “person with ESRD,” or “individual with a confirmed case of hepatitis.”

Incorrect: She was the first documented case in the state.

Correct: She had the first documented case in the state.

Incorrect: Cases are typically 15–25 years of age.

Correct: People with this condition are typically 15–25 years of age.

comprise / compose / consist Minimize use of the word “comprise” because it may distract or confuse readers. To comprise means to include, contain, encompass; the whole comprises the parts. Never use “comprised of.” Depending on the intended meaning, use wording such as “includes,” “contains,” “encompasses,” “is composed of,” consists of, “is made up of.”

Example:

· The target area comprised a medium-sized city and three adjacent ZIP Code areas.

· The target area consisted of a medium-sized city and three adjacent ZIP Code areas.

e.g. / i.e.

The abbreviation “e.g.” is from the Latin exempli gratia and means “for example.” The abbreviation “i.e.” is from id est and means “that is” or “in other words.” These abbreviations are not interchangeable.

Both “e.g.” and “i.e.” are set off by commas.

Examples:

Specify the time zone, for example, Mountain Time.

Specify the time zone, e.g., Mountain Time.

When “e.g.” is used to introduce more than one example, do not add “etc.” at the end of the examples because “e.g.” and “etc.” are redundant.

Examples:

· Specify the time zone, e.g., Eastern Time, Mountain Time.

· Specify the time zone (Eastern Time, Mountain Time, etc.).

provider / practitioner Do not use the term “provider” or “health care provider” to refer to a person. A provider is an entity, not a human being. ESRD providers include dialysis facilities, transplant centers, and other provider settings (e.g., hospitals) that offer ESRD care.

Use “practitioners,” “clinicians,” “health care professionals,” or analogous terms to refer to individuals who provide ESRD care.

they / them / their The plural pronouns “they,” “them,” and “their” can be used as singular to refer to a single individual of unknown gender. However, it is preferable to use “he or she”(or “he/she,” “she/he,” or “s/he”), “him or her” (“him/her,” “her/him”), and “his or her” (“his/her,” “her/his”).

Acceptable: Each student should do their best.

Better: Each student should do his or her best.

timely / timely manner / timely way / on time Do not use “timely” as an adverb.

Not acceptable: Please respond timely.

Acceptable: Please respond in a timely manner.

Acceptable: Please respond in a timely way.

Acceptable: Please respond on time.

Best: Please respond by May 5, 2015.

titled / entitled “Titled” means named. “Entitled” means having the right to.

Examples:

· The article is titled “Improving Care in Nursing Homes.”

· She is entitled to her vacation time.

toward / towards Use “toward,” not “towards.” Both are acceptable in American English, but “toward” is generally preferred.

Example:

The facility is moving toward paperless records.

vaccination / immunization Use “vaccination,” not “immunization,” when referring to the act of administering a vaccine. Use “vaccination rate,” not “immunization rate.” Vaccination rates can be tracked; immunization cannot be tracked.

verbal / oral “Oral” means spoken. “Verbal” means consisting of words. A verbal presentation can be either written or oral.

who / that Use “who” and “whose” to refer to people and “that” to refer to non-human entities.

Examples:

I’ll refer you to the staff member who has the information you need.

I’ll refer you to the ESRD Network that has the information you need.

Occasional exceptions can be made for ease of reading.

Example:

· I work for a company whose motto is “We Care.”

VI. Punctuation

All guidance in Section VI is required.

VI.A. Hyphens and Dashes

In addition to hyphens, the English language uses two types of dashes: en dashes and em dashes. An en dash is longer than a hyphen, and an em dash is longer than an en dash.

No space is used before or after a hyphen, en dash, or em dash.

VI.A.1. Hyphens

A hyphen (-) is used between parts of a compound word or name or between the syllables of a word when the word is divided at the end of a line of text.

Examples:

for-profit state-level

Do not hyphenate compounds formed with adverbs ending in ly.

Examples:

highly paid ethically challenged

VI.A.2. En Dashes

To type the en dash symbol (–) in Microsoft Word, hold down the Control key while typing a hyphen (-) on the number pad. (Note that this does not work with the regular hyphen; it works only with the hyphen on the number pad.)

An en dash is used in ranges of numbers, times, or dates.

Examples:

approximately 80–100 people 10 a.m.–3 p.m.

in 2000–2010 [Do not use “from 2000–2010” or “between 2000–2010.”]

An en-dash is used with inclusive page or section numbers.

Examples:

pages 10–12 Sections 1010–1050

VI.A.3. Em Dashes

An em dash is indicated by either the em dash symbol (—) or two adjacent hyphens. Many word processing systems automatically convert two adjacent hyphens to the em dash symbol.

To type the em dash symbol (—) in Microsoft Word, hold down the Control and Alt keys while typing a hyphen (-) on the number pad.

An em dash can be used in place of a colon.

Example:

The clinic lacked essential supplies—bandages, thermometers, and gowns.

An em dash can be used in place of a semicolon.

Example:

She said no—that was her final answer.

An em dash can be used to set off a parenthetical thought or comment.

Example:

She said—and I agreed—that more discussion was needed.

An em dash can be used to indicate a break in thought.

Example:

He was unhappy with the outcome—but that’s a subject for another time.

VI.B. Parentheses

In general, use standard capitalization and punctuation for material inside parentheses. However, do not use a period or other closing punctuation mark at the end of a sentence embedded within another sentence.

Examples:

She was not feeling well. (She had a fever, aches, and chills.)

She was not feeling well (She had a fever, aches, and chills), so she stayed home from work.

Within parentheses, use brackets for material that would ordinarily be in parentheses.

Example:

The task force included representatives from three federal agencies (the Centers for Medicare & Medicaid Services [CMS], the Centers for Disease Control and Prevention [CDC], and the National Institutes of Health [NIH]).

VI.C. Quotation Marks

Use quotation marks for direct quotes. Do not use quotation marks for indirect quotes.

Examples:

She said, “The meeting is scheduled for noon tomorrow.”

She noted that the meeting is scheduled for noon tomorrow.

Place periods, commas, and question marks within closing quotation marks. Place colons, semicolons, and exclamation points outside of closing quotation marks unless they belong to the material being quoted.

Examples:

“If you need extra time,” said the instructor, “see me after class.”

The patient asked, “Will this medication make me feel better?”

The patient exclaimed, “I feel much better!”; she was very pleased.

Use double quotation marks, not single quotation marks, to convey irony or to suggest doubt about the accuracy, merit, or applicability of a word or phrase.

Examples:

That was the “best case scenario.”

He gave his “final” answer.

Use single quotation marks for a quote within a quote.

Example:

He said, “In the words of John Quincy Adams, ‘facts are stubborn things.’”

Within a quote, use single quotation marks for a word or phrase that is usually enclosed in double quotation marks.

Example:

She noted, “He wrote an article titled ‘Networks Meet the Challenge.’”

Do not use quotation marks with slang expressions or single words when the meaning is clear.

Example:

I found it hard to keep my cool in the meeting.

If a direct quote is longer than five lines, indent the text from the right and left margins and single-space the text. Do not use quotation marks.

Use three periods (called ellipses) to replace text omitted from a direct quote. Use four ellipses to replace text omitted at the end of a sentence.

Examples:

“To be or not to be ... is the question.”

“Life’s but a walking shadow ....”

“Life’s but ... a tale told by an idiot, full of sound and fury, signifying nothing.”

Use brackets around any text or punctuation that differs from the original source.

Examples:

“[It is] a tale told by an idiot, full of sound and fury, signifying nothing.”

“[A] rose by any other word would smell as sweet.”

VII. Data Reporting

All guidance in Section VII is required.

These requirements apply to narrative text, article abstracts, tables, and charts or other figures.

VII.A. Comparisons

When using a comparative term such as “greater,” “larger,” “smaller,” “higher,” “lower,” “more frequently,” or “less frequently,” always make the comparison explicit by specifying the comparison group.

Unclear: Women ages 65 and older have a higher risk of infection.

Clear: Women ages 65 and older have a higher risk of infection than younger women.

Clear: Women ages 65 and older have a higher risk of infection than men in the same age group.

Clear: Women ages 65 and older are at high risk of infection.

Do not use “increased” to mean higher, elevated, or disproportionate compared to another group(s). Increased risk refers to a change in risk over time for a given person or group.

Do not use “x times higher than,” “x times greater than,” “x times more likely than,” etc., because this wording is ambiguous. (Although “three times higher than” is usually understood to mean “three times as high as,” it literally means “four times as high as.”) Use “as high as,” “as great as” or “as likely as” instead.

Unclear: The rate of infection among men was three times higher than the rate of infection among women..

Clear: The rate of infection among men was three times as high as the rate of infection among women.

Use of the words “over” and “under” with quantities (e.g., “Over 100 people attended”) is an advertising technique. Except in promotional materials intended for patients and/or the general public, use more precise terms such as “more than,” “less than,” “fewer than,” “older than,” “younger than,” and so on, instead of “over” or “under.”

Always distinguish between percentage point increases/decreases and percent increases/decreases. For example, an increase from 40% to 50% is both a 10-point increase and a 25% increase.

VII.B. Data Parameters

In reporting data, always specify the timeframe of the data collection and other relevant parameters such as the population that constitutes the denominator and any inclusion/exclusion criteria.

In all mentions of fistula or catheter rates, specify whether the vascular access was in place or in use and specify data parameters.

Do not use the term “prevalent fistula rate.” The rate itself is not prevalent. Use precise wording such as “the rate of fistula use among eligible adult (≥ 18 years of age) in-center hemodialysis patients as of the 4th quarter 2014.”

In all mentions of the catheter use variable, make it clear that the variable represents catheters in use for ≥90 days, i.e., “90 or more days,” not “more than 90 days.”

VII.C. Race/Ethnicity

When reporting data on race/ethnicity, specify the reason for reporting race/ethnicity data and describe how individuals were assigned to racial/ethnic categories. Do not use race and/or ethnicity as a descriptive or demographic variable. In a research article, report race/ethnicity data only when testing one or more specific hypotheses about racial/ethnic differences, and state the hypothesis(es).

Except when writing separately about race and ethnicity, use the combined term “race/ethnicity” (adjective “racial/ethnic”).

The word “Caucasian” refers to people from the Caucasus region and should never be used to refer to the white population of the U.S.

Follow local community preferences in deciding whether to use “African American” or “black”; “Hispanic” or “Latino”; “American Indian” or “Native American”.

Do not use the term “minority” as a noun. Wording such as “member of a minority group” is acceptable; note, however, that the terms “minority” and “minority group” may be offensive to some readers.

Use sensitivity when writing about race/ethnicity. Be careful not to imply that all readers are white, that all members of minority racial/ethnic populations are poor, or that all poor people are members of minority populations. Keep in mind that race and ethnicity are societally defined concepts, not biological categories. There is only one human race, and racial/ethnic categories do not represent genetically distinct populations.

VII.D. Disparities

The term “disparity” refers to a difference between groups, not an attribute or characteristic of any one group. Thus, “disparities among African Americans” means differences between various groups within the African American population.

When reporting disparities, specify the comparison group.

Example:

The results show significant disparities between individuals classified as white and black in the study sample.

The study found significant disparities by income in the target population.

VII.E. Underserved Population Groups

Underserved groups are not necessarily defined by race/ethnicity. For example, a rural area of a state could be medically underserved and/or underserved by the Medicare program.

The term “underserved” should not be applied to an individual or a local racial/ethnic community.

Examples:

CMS defines American Indians/Alaskan Natives as a medically underserved population.

The project focused on Medicare-underserved racial/ethnic groups.

VIII. References

All guidance in Section VIII is required.

Format reference citations consistently using any standard formatting system. For journal articles, use the preferred reference formatting of the journal to which the article will be submitted.

When reporting the current incidence or prevalence of a disease, cite current data, i.e., data that are no more than a year old. If current data are not available, cite the most recent available data and specify the timeframe of the data cited.

Do not cite a secondary source of data when a primary source is available. For example, do not cite Census data from a source other than the Census Bureau.

When citing a reference in a PowerPoint presentation, give the full citation or provide enough information to allow members of the audience to look up the cited article.

IX. Tables and Figures

All guidance in Section IX is required.

In labeling a table or figure, provide sufficient information to allow the table or figure to “stand alone.” The title, all row/column labels or axis labels, and any footnotes should provide sufficient detail to allow readers to understand the data parameters and data source(s) at a glance.

Do not use the word “below” to refer to a table or figure that immediately follows. “Below” implies much later on in the document.

IX.A. Required Elements of a Table

Number of Primary Care Physicians per 1,000 Residents and Percent of Medicare Beneficiaries Enrolled in Managed Care Plans, Selected U.S. Cities, 2014Use a detailed, descriptive title.

CityUse row labels that are precise and descriptive.

IX.B. Required Elements of a Chart

Use a detailed, descriptive title.

Include a legend.

Label the y-axis.

Never use three-dimensional bars.

Label the x-axis.

Helpdesk Requests by Month and Time of Day a.m.

Number of Requests