Referencing is essential and integral part of scientific research, writing and publication.

1. References and citation in medical writing
Dr Rashmi Surti
Head- Global Medical affairs(Pharma Health Care)
Megawecare pvt ltd.

2. Learning outcomes
• You will know why correct referencing is essential
• You will know what are different reference style
• You will know what citations are and when and how to cite in the text
• You will be able to reference some key sources of information
including books, journal articles and websites

3. Introduction
• Referencing is essential and integral part of scientific
research, writing and publication.
• Format and style of references are as varied as the
number of journals currently present.
International Committee of Medical Journal Editors in their latest
recommendations for publication, advice authors to quote original
references whenever possible.
Indian J Orthop. 2019 May-Jun; 53(3): 381–383.

4. What is referencing?
• Referencing is a standardized way of acknowledging the sources of
information and ideas that you have used in your assignments and which
allows the sources to be identified.
• It is an essential part of any scientific document.
• A referencing style is a specific format for presenting your in-text references
(footnotes or endnotes), and bibliography.
• Copying other’s ideas and works without proper acknowledgements of
source is a serious misconduct, the plagiarism.
• It is important to be consistent when you are referencing.
Journal of Patan Academy of Health Sciences. 2019Jun;6(1):1-5.

5. Why Citation of Sources/reference is Important
When Writing
1. Attribution serves as a fact-checking tool.
2. Citation makes you a better researcher.
3. Good citation practices make you a better writer.
4. A good bibliography shows off your scientific knowledge.
5. Careful citation practices will build your credibility as a scientist or scholar.
6. Citation enables better verification of your work.
7. Citations help you steer clear of plagiarism.
8. To acknowledge others work
9. Add credibility to one’s own work
1. Neeraja Sankaran, Ph.D. 6 Reasons Why Citation of Sources is Important When Writing. Falcon editimg.com. 2016. Accessed on 20-6-2020
2. Journal of Patan Academy of Health Sciences. 2019Jun;6(1):1-5.

6. What are references and citations?
Citation
Reference
Reference list
Bibliography
Appears in the text of your document, wherever you use a quote
or incorporate an idea you have picked up from another source
Appears at the end of your document, or sometimes at the bottom of each
page, and gives full details of the source of your information
A list at the end of a document giving full details of sources cited
within the document
A list at the end of your document which gives the full details of all
sources which you have read even if they are not referred to within the
text

7. Citation required No citation
required
You are quoting directly from another source
Mention a fact that is commonly known
Present the results of your own survey or experiment
You are writing about another researcher’s theory or idea using your
own words, as a paraphrase or a summary
You use an image from the web
You are using facts and figures from another writer to support your idea
You use a diagram from a book
You include some statistics that your lecturer has given you in a lecture
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x
x

8. Basic format to reference journal articles
1. Author or authors. The surname is followed by first initials.
2. Year of publication of the article (in round brackets).
3. Article title.
4. Journal title (in italics).
5. Volume of journal (in italics).
6. Issue number of journal in round brackets (no italics).
7. Page range of article.
8. DOI or URL
Digital object identifier

9. Referencing styles

10. The 2 common - Priorities

11. 2 basic styles
References are formatted in two basic styles
 The Vancouver style which is numeric (more commonly used in medical
journals) and
The Harvard which uses author-date style (more commonly used in natural
and Social sciences journals)
https://guides.library.vcu.edu/citation-styles. Last Updated: Jan
7, 2022

12. Vancouver Referencing Style

13. Vancouver style of referencing
The style of referencing commonly used in Medicine is called the Vancouver
style.
You can see examples of it in important medical journals, such as the BMJ
(British Medical Journal) or The Lancet. It is a numbered style.
Every reference has a number, and references are in a list at the end of
the document in the order they were cited in the document.
It was developed in Vancouver in 1978 by editors of medical journals and well
over 1,000 medical journals (including ICMJE members BMJ, CMAJ, JAMA &
NEJM) use this style
https://michener.ca/students/library/referencing-writing-help/vancouverstyle/

14. History
• A small group of editors of general medical journals met informally in
Vancouver, British Columbia, in 1978 to establish guidelines for the format of
manuscripts submitted to their journals.
• • This group became known as the Vancouver Group. Its requirements for
manuscripts, including formats for citations and references were first
published in 1979 by the National Library of Medicine (NLM).
• • The Vancouver Group expanded and evolved into the International
Committee of Medical Journal Editors (ICMJE), which meets annually.

15. Vancouver style, authors name
• In Vancouver style referencing, the author/s are traditionally listed as
proposed by western culture- “family space name full stop.
• Publication from Asian culture, especially Chinese (who write their name
starting with family name first), now constitute significant proportion in the
online literature).
• Up to six authors, all are listed, in case of more than six , list first six and then
use et al.
• Some journals have et al after three authors.
• Et al. comes from the Latin phrase meaning “and others.
Journal of Patan Academy of Health Sciences. 2019Jun;6(1):1-5.

16. Vancouver style, notational method
• Vancouver Style uses a notational method of referencing when referring to a
source of information within the text of a document.
• In its simplest form, a number in parentheses (round brackets) placed in the text of the
essay, indicates the relevant reference:
https://libguides.murdoch.edu.au/Vancouver. Last Updated: May 18, 2021 10:01 AM

17. Reference Types
Articles in Journals
Books and Other Monographs
Other Published Material
Unpublished Material
Electronic Material
https://www.nlm.nih.gov/bsd/uniform_requirements.html. Last
Reviewed: April 26, 2018

18.  Journal articles and Cochrane reviews

19. Articles in Journals- Standard journal article

20. Organization as author- Diabetes Prevention Program Research Group. Hypertension, insulin, and
proinsulin inparticipants withimpairedglucosetolerance.Hypertension.2002;40(5):679-86.
No author given
21st century heart solution may have a sting in the tail. BMJ. 2002;325(7357):184.
Article not in English
• Ellingsen AE, Wilhelmsen I. Sykdomsangst blant medisin- og jusstudenter. Tidsskr Nor Laegeforen.
2002;122(8):785-7.Norwegian.
• Ellingsen AE, Wilhelmsen I. [Disease anxiety among medical students and law students]. Tidsskr Nor
Laegeforen.2002 Mar 20;122(8):785-7.Norwegian.

21. Article with published erratum
Malinowski JM, Bolesta S. Rosiglitazone in the treatment of type 2 diabetes
mellitus: a critical review. Clin Ther. 2000;22(10):1151-68; discussion 1149-50.
Erratum in: Clin Ther. 2001;23(2):309.
Article published electronically ahead of the print version
Yu WM, Hawley TS, Hawley RG, Qu CK. Immortalization of yolk sac-derived
precursor cells. Blood. 2002 Nov 15;100(10):3828-31. Epub 2002 Jul 5.

22. Volume with supplement
Geraud G, Spierings EL, Keywood C. Tolerability and safety of frovatriptan with
short- and long-term use for treatment of migraine and in comparison with
sumatriptan. Headache. 2002;42 Suppl 2:S93-9.
Issue with no volume
Banit DM, Kaufer H, Hartford JM. Intraoperative frozen section analysis in revision total
joint arthroplasty. Clin Orthop. 2002;(401):230-8.
No volume or issue
Outreach: bringing HIV-positive individuals into care. HRSA Careaction. 2002 Jun:1-6.
Pagination in roman numerals
Chadwick R, Schuklenk U. The politics of ethical consensus finding. Bioethics.
2002;16(2):iii-v.

23. Author(s) or editor(s) (if editors, include ed. or eds.). If you have more than six
authors/editors, list only the first three followed by “et al”
Book title (in italics, in Title Case)
Volume number and title (if there is more than one volume)
Edition number (if it is not the first edition)
Publisher's name
Latest copyright year
 Books and Other Monographs

24. Personal author(s)
Murray PR, Rosenthal KS, Kobayashi GS, Pfaller MA. Medical microbiology. 4th ed.
St. Louis: Mosby; 2002.
Editor(s), compiler(s) as author
Gilstrap LC 3rd, Cunningham FG, VanDorsten JP, editors. Operative obstetrics. 2nd
ed. New York: McGraw-Hill; 2002.
Author(s) and editor(s)
Breedlove GK, Schorfheide AM. Adolescent pregnancy. 2nd ed. Wieczorek RR,
editor. White Plains (NY): March of Dimes Education Services; 2001.
Organization(s) as author
American Occupational Therapy Association, Ad Hoc Committee on Occupational
Therapy Manpower. Occupational therapy manpower: a plan for progress.
Rockville (MD): The Association; 1985 Apr. 84 p.

25. Chapter in a book
Meltzer PS, Kallioniemi A, Trent JM. Chromosome alterations in human solid tumors. In: Vogelstein
B, Kinzler KW, editors. The genetic basis of human cancer. New York: McGraw-Hill; 2002. p. 93-
113.
Patent
Pagedas AC, inventor; Ancel Surgical R&D Inc., assignee. Flexible endoscopic grasping and
cutting device and positioning tool assembly. United States patent US 20020103498. 2002 Aug
1.

26.  Other Published Material
Newspaper article
• Tynan T. Medical improvements lower homicide rate: study sees drop
in assault rate. The Washington Post. 2002 Aug 12;Sect. A:2 (col. 4).

27. Journal article on the Internet
Abood S. Quality improvement initiative in nursing homes: the ANA acts in an advisory
role. Am J Nurs [Internet]. 2002 Jun [cited 2002 Aug 12];102(6):[about 1 p.]. Available
from: https://journals.lww.com/ajnonline/Fulltext/2002/06000/Quality_Improvement_Initiat
ive_in_Nursing_Homes.31.aspx
Article with a Digital Object Identifier (DOI):
Zhang M, Holman CD, Price SD, Sanfilippo FM, Preen DB, Bulsara MK.
Comorbidity and repeat admission to hospital for adverse drug reactions in older
adults: retrospective cohort study. BMJ. 2009 Jan 7;338:a2752. doi:
10.1136/bmj.a2752. PubMed PMID: 19129307; PubMed Central PMCID:
PMC2615549.

28. Monograph on the Internet
Foley KM, Gelband H, editors. Improving palliative care for cancer [Internet].
Washington: National Academy Press; 2001 [cited 2002 Jul 9]. Available
from: https://www.nap.edu/catalog/10149/improving-palliative-care-for-cancer.
Homepage/Web site
eatright.org [Internet]. Chicago: Academy of Nutrition and Dietetics; c2016
[cited 2016 Dec 27]. Available from: https://www.eatright.org/
Blogs
Holt M. The Health Care Blog [Internet]. San Francisco: Matthew Holt. 2003
Oct - [cited 2009 Feb 13]. Available
from: http://thehealthcareblog.com/blog/category/matthew-holt/.

29.  Guideline

30.  Webpage

31.  Poster presentation/session presented at a
meeting or conference:

32. Important notes
• There are no spaces between the year, volume, issue number and page numbers.
• If there is a DOI you should always include it at the end of the reference.
• DOIs can be formatted either as metadata: (e.g. doi:10.1001/jama.2017.13737) or as a
URL (e.g. https://doi.org/10.1002/jmv.26408). Whichever you choose, it is best to be
consistent with formatting.
• You only need to include an Accessed date if you have used a URL.
• Use the URL that will take the reader directly to the article; do not include a long search
string, and also avoid a short, more general URL (eg, one to the publisher’s
homepage). Always include “https://” before the URL to help ensure proper linking;
most sites with “http://” have changed to the more secure “https://”. The URL is not
followed by a period.
• For some electronic journals, the articles are never published in a print format, and do
not give meaningful page numbers. In this case, use the article's identifier or e-Locator
in the place of page numbers.

33. Harvard Referencing Style

34. Harvard referencing style
• Harvard referencing style uses references in two places in
a piece of writing: in the text and in a reference list at the
end.
• In general, each author name that appears in the text
must also appear in the reference list, and every work in
the reference list must also be referred to in the main text

35. Journal articles- Harvard style
https://www.adelaide.edu.au/writingcentre/sites/default/files/docs/harvard-referencing-guide.pdf

36. Book reference- Harvard style
https://www.adelaide.edu.au/writingcentre/sites/default/files/docs/harvard-referencing-guide.pdf

37. Examples of Harvard and Numeric
For comparison purposes, here is an example of a book referenced
using the 2 methods:
Harvard
Jones, S. and Brown, F. 1998. Citing and referencing published
material. 3rd ed. London: British Institution.
Numeric
Jones, S. and Brown, F. Citing and referencing published material.
3rd ed. London: British Institution, 1998.

38. Citation Styles In NLM Medical
Referencing

39. Citation Styles in NLM Medical Referencing
Three citation styles than you can use in medical writing:
• Citation-sequence – This style uses numbered citations, with sources listed
at the end of your document in the order they are first cited.
• Citation-name – This is the same as the citation-sequence style, but sources
in the reference list are organized alphabetically by author surname rather
than sequentially.
• Name-year – This version uses bracketed in-text citations that include the
author’s surname and the year of publication for the source. Cited sources
are then listed alphabetically by author surname in the reference list at the
end of your document.

40. In text citations

41. Citation-Sequence Referencing
• NLM’s citation-sequence referencing style is a version of Vancouver referencing.
Essentially, each citation number in the text points to a source in the reference list, like
this:
• The treatment was effective for 80% of patients.1
• All sources are numbered in the order they are first cited. The superscript “1” at the end
of the sentence above, for instance, would point to the first source in the reference list.
If we were then to cite the same source again later, we would repeat the same number
as on the first citation.
• We could also cite the source above in brackets, for example:
• The treatment was effective for 80% of patients (1).
https://getproofed.com/writing-tips/citation-styles-nlm-medical-referencing/

42. Name-Year Citations
• NLM’s name-year citations are a version of Harvard referencing. This
means that we cite sources by giving the author’s surname and a
year of publication in brackets. For example:
• The treatment was effective for 80% of patients (Smith 2014).
https://getproofed.com/writing-tips/citation-styles-nlm-medical-referencing/

43. Common ways
• The two most common ways by which references throughout a
document are identified are:
1. Using superscripted numbers such as – 1 or 2 etc
2. Enclosing numbers in brackets, such as – (1) or (2) etc
https://www.jli.edu.in/blog/why-referencing-referencing-styles-in-
medical-writing/

44. Creating a reference list
• A reference list is created at the end of your document which outlines
all the sources that you have referenced in your document.
• Sometimes, you may also create a bibliography which is a full list of
all sources consulted when researching your assignment, whether
referenced in the work or not.
• A bibliography may also be a separate work, listing sources published
on a particular topic.
https://www.nottingham.ac.uk/studyingeffectively/writing/referencing/index.aspx

45. To sum up:
• Referencing is essential and integral part of scientific/medical writing
• Accurate referencing is a key component of good scientific writing and
enhances the presentation of your work.
• Citation makes you a better researcher.
• It is important to be consistent when you are referencing.
• Vancouver is a numerical referencing system and is commonly used
in Medicine and the Sciences.
• Avoid plagiarism

46. Thank you!