AMA Manual of Style - Stacy L. Christiansen, Cheryl Iverson 2020
First Word of Sentences, Quotations, Titles, and Subtitles
The first word of every complete sentence should be capitalized.
Capitalize the first word of a direct quotation (but see 8.6.1, Quotation Marks, Quotations).
The speaker made the following observation: “There are limitations inherent to the use of rotational flaps.”
Note: If the quotation is not a full sentence itself, a lowercase letter on the first word is preferable.
The patient described her headache pain as feeling like “needles behind the eyes.”