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I'm an academic editor in the field of medicine and I often come across complex comparisons. My question is specifically regarding how the placement of the verb affects the the parallelism of the comparison.

Please check the following three sentences:

  1. Median serum thyroxine was significantly decreased in patients with a suppressed TSH compared to those with a normal TSH.

  2. Median serum thyroxine was significantly decreased in patients with a suppressed TSH compared to that in patients with a normal TSH.

  3. Median serum thyroxine in patients with a suppressed TSH was significantly decreased compared to that in patients with a normal TSH.

To the best of my knowledge, sentences 1 and 3 are accurate in terms of parallelism. However, a couple of my friends agree that 1 is wrong and 2 is right. We all agree on 3 being the best form.

I would like to know your opinion regarding the same. In particular, if someone can link me to any resources regarding the changes that need to be made according to the placement of the verb for maintaining parallelism in such comparisons, it would be great.

Thanks!

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    You're trying to do too much work with pronouns and parallelism. To start with, it's a level of thyroxine you're measuring, right? So use level as your anaphor: compared to the median level in patients... Then you can put the whole phrase anywhere (and parallelism helps, for sure) because everything's anchored and nothing meaningful is deleted.
    – John Lawler
    Commented Jun 19, 2014 at 16:31
  • 1
    @JohnLawler - thank you so much. I was hoping you'd comment on this. I just did a lengthy analysis, and really wanted a linguist to put it in the proper terminology.
    – anongoodnurse
    Commented Jun 19, 2014 at 16:36
  • Also, when something "decreases" or "is decreased," the comparison most obviously implied is between that something now and the same thing previously.
    – Brian Donovan
    Commented Jun 19, 2014 at 17:32
  • @SvenYargs - no, that is not what anyone who understood the sentence would think. The fact is that the meds given to the patients suppress TSH (thus serum thyroxin levels) patients. It is iatrogenic in that way. Your comment makes no sense at all. Best to just remove it.
    – anongoodnurse
    Commented Jun 25, 2014 at 3:45
  • Thanks, medica. As you recognized, I approached the sentence without any knowledge of the factual matrix underlying it. I've removed my comment.
    – Sven Yargs
    Commented Jun 25, 2014 at 16:00

1 Answer 1

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Median serum thyroxine was significantly decreased in patients with a suppressed TSH compared to those with a normal TSH.

What does "those" refer to?

Median serum thyroxine is one value (level) at the midpoint of the levels of a group of patients. Got it. But in the comparison group, you use those. It's ambiguous to me, because I presume "those" refers to the median serum thyroxine (level) in the unsuppressed patients, which should be a single value as well.

To me, it has nothing to do with verb placement, but rather to the referent. "Those" refers not to patients (plural) but a median level (singular). Restated:

Median serum thyroxine [level, singular] was significantly decreased in patients [plural] with a suppressed TSH compared to those [levels, plural? patients, plural?] with a normal TSH.

Compare to #2:

Median serum thyroxine [level, singular] was significantly decreased in patients [pl] with a suppressed TSH compared to that [level, singular] in patients [pl] with a normal TSH.

All those match up. Your pronoun/determiner matches in number to your first noun (level).

Compare to #3:

Median serum thyroxine [level, singular] in patients [pl] with a suppressed TSH was significantly decreased compared to that [level, singular] in patients [pl] with a normal TSH.

There isn't anything tricky about the verbs. If you referred to the hormone level instead of leaving that floating in the ether somewhere, I don't think you would run into the problem you have grappled with.

I'm a doc. That'll be $150.00. Please send me your email address so that I can forward my bill. J/k about the bill. Not kidding about being a doc.

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