January 31, 2013

Weekly Language Usage Tips: double blind or blinded & youth or youths

Posted in double blind/blinded, youth/youths at 6:24 am by dlseltzer

Tip 1: Double blinded or double blind

A reader writes:

Quick question:

Is it double-blind, randomized controlled trial OR double-blinded, randomized controlled trial???

It is a mouthful either way.😉

Quick answer: It’s double blind.

Longer answer: It is still double blind, but I wanted to talk about it a little and mention the CONSORT Statement of 2010. Blinding occurs when some or all of the study participants involved in the experiment do not know what the intervention is (often a treatment or placebo). The trouble with using the term ‘double blind’ in reference to randomized controlled trials (RCTs) is that not everyone defines it the same way, so unless we specify who is being blinded, we don’t have the information we need to evaluate the study. For some people, double blinding may refer to the study participant and the health care provider (HCP) treating the participant. For others, double blinding may refer to the study participant and the investigator or analyst assessing the outcomes.

Further compounding the problem is that investigators, when reporting the results of RCTS, often did not report whether the study was blinded at all.

To remedy flaws in reporting the results of RCTs, an international group of medical journal editors, trialists, and methodologists came together to codify standards for reporting the results of RCTs. Thus, the Consolidated Standards of Reporting Trials (CONSORT) came to be. For many high impact journals, reporting according to the CONSORT statement is mandatory.

From the CONSORT Statement of 2010:

… authors can and should always state who was blinded (that is, participants, healthcare providers, data collectors, and outcome adjudicators).

 Unfortunately, authors often do not report whether blinding was used. For example, reports of 51% of 506 trials in cystic fibrosis, 33% of 196 trials in rheumatoid arthritis, and 38% of 68 trials in dermatology did not state whether blinding was used. Until authors of trials improve their reporting of blinding, readers will have difficulty in judging the validity of the trials that they may wish to use to guide their clinical practice.

[For references, please see:

Schulz KF, Altman DG, Moher D, for the CONSORT Group. CONSORT 2010 Statement: updated guidelines for reporting parallel group randomised trials. Ann Int Med 2010;152. Epub 24 March.

Or their website:  http://www.consort-statement.org/%5D

 Folks have also asked whether it is a randomized control trial or a randomized controlled trial.

Quick answer: It’s a randomized controlled trial.

Tip 2: Youth or youths

I was reading a manuscript recently and read this sentence:

Approximately 30% of youth in grades 6 through 10 were found to have trace levels of XYZ in their blood.

 Hmm, I thought. That isn’t right. It should be:

 Approximately 30% of youths in grades 6 through 10 were found to have trace levels of XYZ in their blood.

 That ‘s’ is very important here. The rule is simple, but you’d never guess it by the furious discussions on the Internet. Some of the arguments struck me as really bizarre such as: Never use ‘youths’ because that means ‘young men involved in some criminal activity.’ Say what? I finally figured out that this is another American versus British thing. In Great Britain, it seems that ‘youths’ is used as a synonym for ‘delinquent boys.’ I didn’t find that meaning in the Oxford English Dictionary, but most citations supporting such use appeared to be British. It certainly is not true in America where girls or young women are considered ‘youths,’ and there is no implication of criminal activity or delinquency.

But I digress. As I said the rule is simple. If you are talking about young people in general, as in:

The youth of the United States

The world’s youth

then, ‘youth’ is a collective noun, and the plural form is the same as the singular form, ‘youth.’

If you are talking about specific young people or a group that can conceivably be counted, as in:

30% of youths

That group of youths sitting in the last row

then, the plural is formed by adding an ‘s’ to the word. In this case, ‘youth’ is singular, and ‘youths’ is plural.



  1. Frankie said,

    I don’t think “youths” is used as a synonym for young men involved in some criminal activity in British Enlgish. That might be “yob”. “A youth” can refer to a young man and “youths” to young men, but “youth” is also young people in general, as in American English. The example you give is not correct in British English – quite apart from the fact that we wouldn’t say “grades 6 through 10”.🙂
    Rant over.

  2. ObsessiveTruthSeeker said,

    Is there a difference between “should” and “must”? Can they be used interchangeably?

    • dlseltzer said,

      There is a difference, and they should not be used interchangeably. Should implies that someone is supposed to do something. Must implies that someone HAS to do something. I know some dictionaries call them synonyms but I would maintain the different nuances.

      • ObsessiveTruthSeeker said,

        Thank you for the clarification (and also for the wonderful WLUT blog). Can you please add my e-mail obsessivetruthseeker@gmail.com to your e-mail list.

        Thank you.

      • dlseltzer said,

        Done. Welcome.

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