Title tattles

In last year's Holiday Review, Associate Editor Erica Weir guided us through the perplexities of authorship, onomastics and the intellectual struggles of the Vancouver Group.¹ She suggested that linguistic incoherence often arises between authors' names and the subject matter of their work, and offered compelling examples.

I suggest that a more proximal problem, coherence of the title itself, also needs our attention. If coherence is abandoned in the first words of the paper, there seems little purpose in pursuing its content.

Here is an example of a title that wandered off in pursuit of precision: “Increased risk of death from measles in children with a sibling of the opposite sex in Senegal.”²

My daughter's grade 10 class found this one mathematically unthinkable: “The association between hospital volume and survival after myocardial infarction in elderly patients.”³

Some titles are born illogical: “Maternal and fetal outcomes of subsequent pregnancies in women with peripartum cardiomyopathy.”⁴

Some achieve illogic: “Rethinking the role of tube feeding in patients with advanced dementia.”⁵

And some have illogic thrust upon them: “Housing dynamics of the homeless: implications for a count.”⁶

The following title might lead us to imagine that only machines and monitors live, breathe and practise medicine: “Benefits of implantable defibrillators are overestimated by sudden death rates and better represented by the total arrhythmic death rate.”⁷

A title ought to serve its author by holding up what is described beneath. Readers decide whether to look at an article first by reading its title. These days, a naïve search of the medical literature starts with the title. The more we search electronically for subject matter by title content, the more we are going to find ourselves down dark and blind alleys with nary a candle to light our way unless authors give us more illuminating titles.

Signature

Ken Flegel
Associate Editor, CMAJ McGill University Montreal, Que.