AMA Manual of Style - Stacy L. Christiansen, Cheryl Iverson 2020
Modifiers
Grammar
A modifier describes another word or word group. Words, phrases (groups of words without a subject or predicate, usually introduced by a preposition or conjunction), and clauses (groups of words with a subject and verb within a compound or complex sentence) may all be modifiers. An adjective modifies a noun or a pronoun. An adverb modifies a verb, an adjective, another adverb, or a clause. Clauses or phrases may serve as adjectives or adverbs.
7.6.1 Misplaced Modifiers.
Misplaced modifiers result in failure to make clear what is being modified. Illogical or ambiguous placement of a word or phrase can usually be avoided by placing the modifying word or phrase close to the word it modifies.
Unclear: |
Dr Young treated the patients using antidepressants. [Who used the antidepressants? Ambiguity makes 2 meanings possible.] |
Better: |
Dr Young treated the patients with antidepressants. or Dr Young treated the patients who were using antidepressants. [alternative meaning] |
Unclear: |
The patient was referred to a specialist with severe bipolar disorder. [Who had the bipolar disorder?] |
Better: |
The patient with severe bipolar disorder was referred to a specialist. |
Likewise, sometimes it is necessary for clarity to place an adverb within a verb phrase. Note the shift in meaning when the adverb is moved outside the verb phrase.
He had just called me.
He had called just me.
Use of the word only as a modifier poses particular issues. Only should be placed immediately before the word or phrase it modifies for the meaning to be clear. The different meanings depend on placement in the examples below.
Only medication can ease the pain.
Medication only can ease the pain.
Medication can only ease the pain.
Medication can ease only the pain.
Medication can ease the only pain.
Medication can ease the pain only.
7.6.2 Verbal Phrase Danglers.
A participle is a verb form used as an adjective. A dangling participle implies an actor but fails to indicate correctly who or what that actor is. The following examples of dangling participles illustrate the problem.
Avoid: |
Working quickly, the study was completed early by my research team. [The participle appears to refer to the study; however, it is the research team that was working quickly.] |
Better: |
My research team worked quickly and completed the study early. or The study was completed early because my research team worked quickly. |
Avoid: |
Based on our experience, educational interventions are needed to foster higher-quality end-of-life care. [Are the educational interventions based on the authors’ experience? No—it is the statement about the need for higher-quality end-of-life care that is based on the authors’ experience.] |
Better: |
We have found that educational interventions are needed to foster higher-quality end-of-life care. or Experience has shown that educational interventions are needed to foster higher-quality end-of-life care. |
A gerund is a verb form used as a noun (see 7.1.2, Modifying Gerunds). Like the dangling participle, the dangling gerund implies an actor but does not specify who or what that actor is and sometimes may be confused with a participle modifying the wrong entity.
Avoid: |
Dietary therapy slows the return of hypertension after stopping long-term medical therapy. [This states that dietary therapy not only slows the return of hypertension but also stops medical therapy.] |
Better: |
Dietary therapy slows the return of hypertension after cessation of long-term medical therapy. or After the patient discontinues long-term medical therapy, dietary therapy slows the return of hypertension. |
Avoid: |
Before initiating an exercise program or engaging in heavy physical labor after a myocardial infarction, a physician should review the exercise program carefully. [A physician is erroneously implied to be the actor, the one initiating an exercise program or engaging in heavy physical labor.] |
Better: |
Anyone about to initiate an exercise program or engage in heavy physical labor after a myocardial infarction should consult a physician. |