Exploring Within-Discipline Variation of Lexical Bundle Use: An Example from Medical Research Articles and Medical Case Reports

Mbodj, Ndeye Bineta; Cortes, Viviana

doi:10.1590/1984-6398202550012

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Thematic Dossier • Rev. bras. linguist. apl. 25 (1) • 2025 • https://doi.org/10.1590/1984-6398202550012 linkcopy

Exploring Within-Discipline Variation of Lexical Bundle Use: An Example from Medical Research Articles and Medical Case Reports

Explorando a variação intradisciplinar do uso dos grupos lexicais: um exemplo de artigos de pesquisa médica e relatos de casos médicos

Authorship SCIMAGO INSTITUTIONS RANKINGS

Studies that focus on the use of formulaic language in academic writing primarily investigated the use of different types of formulaic sequences in academic research articles in various disciplines. These studies revealed dramatic variations in the use of formulaic language across academic disciplines (e.g., Cortes, 2004; Hyland, 2008; Jalali; Moini, 2014; Shahriari, 2017). However, there is evidence that discipline alone may not be enough to determine linguistic variation (Gray, 2015), as different registers within one discipline may reflect different linguistic characteristics depending on specific communicative purposes (Biber; Conrad, 2019). In the case of medical written discourse, different medical registers may call for the use of different formulas to convey different communicative intents. This is the case of the medical research article (MRA) and the medical case report (MCR). In this study, we will focus on the identification and analysis of lexical bundles in medical discourse, particularly in MRAs and MCRs. Lexical bundles (Biber et al., 1999) are groups of three or more words that frequently occur in a given register. They are identified empirically, using specially designed computer programs that run through the texts in a language corpus and flag expressions of three or more words that repeat frequently, employing a strictly corpus-driven approach (Cortes, 2015). Using specially designed software, lexical bundles of 3+ words were identified in each corpus. These expressions were later analyzed according to their structure and the functions they performed to conduct a comparison across the two registers using taxonomies adapted from the literature (Biber; Conrad; Cortes, 2004; Hyland, 2008).

Keywords:
lexical bundles; medical discourse; register variation

Categories	Examples
Participants	Authors, actual writers, professional training/title, and primary audience
Textual layout and organization	Word count, headings, use of abstract, visual elements, and sections/organization
Setting	Type of journal
Subject/topic	Main themes in texts
Purpose	Introduce a case to the medical community
Nature of data or evidence	Presence of observe data, use of numerical evidence, object of study, and primary presentation of evidence
Methodology	Observational, experimental, and use of statistical techniques
Explicitness of research design	Explicitness of purpose, of research questions, of citations, in-text reference to cited authors, explanation of evidence and explanation of procedures

Corpus	Journals	Number of texts	Mean word count per text	SD	Total word count
MRAC	JAMA JCI The Lancet NEJM Science TM	250	4,846	1,527.35	1,209,367
MCRC	JAMA BMJCR JMCR OMCR IMCRJ	704	1,428.8	624	1.005.907

Bundle Length	Frequency pmw	Range
3 words	20	10
4 words	20	10
5 words	10	10
6 words	8	8
7 + words	6	6

Main Categories	Subcategories	Examples from the MRAC and MCRC
Verb phrase-related	Passive verb	were included in the, the patient was started on
	Copular be	were eligible for, is the most common
	Imperative	see the supplementary appendix
	Modals	can be a, may lead to, can also be
Clause-related	Anticipatory it	it is possible that, it is important to
	Abstract subject	his blood pressure was
	Human subject	our patient presented with
	External subject	confirmed the diagnosis of
	As-fragments	as measured by, as described previously
	There fragments	there was no family history of
	(NP) + wh-fragments	when compared with, patients who were
	(VP) + that-fragments	these data suggest that, we found that the
	(VP) + to-fragments	to assess the effect of, to confirm the diagnosis
Noun/Preposition-related	NP with of-phrase fragment	the onset of, a single dose of, a wide range of
	NP with other post modifier fragments	a man in his, death from any cause
	PP with embedded of-fragment	at the end of the, at the time of diagnosis
	Other prepositional fragments	in individuals with, in addition to the
	Comparative expressions	as in this case
Adj & Adv-related	AdjP /AdvP + PP fragment/to-inf	consistent with the, more likely to
	Superlatives	the most common
Function-word only (3-words only)	Function words only	as in our, and in the, but not in

Categories	Subcategories	Examples from the MRAC
Research-oriented (Structure writers’ experiences / activities)	Location (in time/place)	during the study period, at the university of
	Procedure	the use of, by western blotting
	Quantification	the number of, a total of, the proportion of
	Description	the effect of, the risk of, was defined as the
Text-oriented (Organize text and its meaning)	Transition signals	as well as, on the other hand
Text-oriented (Organize text and its meaning)	Resultative signals	these findings suggest that, as a result of
	Structuring signals ◆ Text reference ◆ Study subject/elements reference	in the present study, are shown in table of patients with, in patients with
	Framing signals	on the basis of, with respect to the
Participant-oriented (Focus on writer or reader)	Stance features	it is possible that, may not be
Participant-oriented (Focus on writer or reader)	Engagement features	it should be noted that
Grammatical only		to that of, any of the, that of the

Categories	Subcategories	Examples from the MCRC
Case-related (presentation and discussion of case)	Description ◆ Medical condition-related	we present the case of, has been shown to be
	◆ Subject-related	a woman in her, man with a history of, she had a
	Location (time/place)	at the time of admission, to the emergency department
	Quantification	a high index of suspicion, at a dose of
Diagnosis & Intervention- related (writers’ activities and decisions)	Procedure	she was treated with, the patient underwent a
	Result Reporting	with a blood pressure of, was positive for
	Decisions/ Outcome	the decision was made to, complete resolution of
Discourse Organizers	Transition signals	in addition to the, on the other hand, as well as
	Resultative signals	as a result of, due to the presence of
	Structuring signals ◆ Text reference	are shown in, reported in the, in this report
	◆ Study subject reference	of these patients, of our patient
	Framing signals	based on the, depending on the, in the absence of other
Grammatical only		and did not, in which the, he did not, it has been
Stance & Engagement	Stance features	may lead to, it is possible that, may be associated with
	Engagement features	should be considered in, physicians should be aware of

MRAC			MCRC
Structure	Percentage	Example	Structure	Percentage	Example
Noun-Prep related	53%	of the right eye	Noun-Prep related	50%	an increase in the
Verb-Phrase related	22%	showed no evidence	Verb-Phrase related	26%	had no effect on
Clause-related	17%	we did not observe	Clause-related	20%	we report a case
Adj/Adv related	4%	likely to be	Adj/Adv related	3%	consistent with a
Function-word only	4%	to that of	Function-word only	1%	as in our

	3-words	4-words	5-words
Raw #_Shared	88	29	5
% _MRAC	24.31%	25%	15.50%
%_ MCRC	32.59%	20.42%	8.20%

	3-words	4-words	5-words
Description	37	8	2
Quantification	10	2
Location (in time)	5	4	2
Procedure	6	3
Resultative signals	12	1
Framing signals	8	6
Transition signals	1	4	1
Structuring (text reference)	1	0
Grammatical only	7	0
Stance	1	1
Totals	88	29	5

	MRAC Bundles: Raw Number (%)
Main Functions	3-words	4-words	5-words	6-words	7-words	8-words	11-words
Research-Oriented	218 (60.22%)	65 (56.03%)	25 (62.50%)	7 (58.33%)	0%	1 (100%)	1 (100%)
Text-Oriented	143 (39.50%)	51 (43.97%)	14 (35%)	5 (41.67%)	1 (100%)	0%	0%
Participant-Oriented	8 (2.21%)	2 (1.72%)	2 (5%)	0%	0%	0%	0%
Grammatical only (3-words only)	3 (0.83%)
Total # of bundles	362	116	40	12	1	1	1

Bundle size	Description	Quantification	Procedure	Location Time/Place
3-word	38.07%	22.02%	29.36%	10.55%
4-word	43.08%	24.62%	21.54%	10.77%
5-word	50%	4%	29%	17%
6-word	43%	--	43%	14%

Bundle length	Framing signals	Structuring signals (study subject/elements reference)	Structuring signals (text reference)	Resultative signals	Transition signals
3-words	23.78%	14.69%	16.08%	32.16%	11.19%
4-words	23.53%	9.80%	9.80%	35.2%	21.57%

	MCRC Bundles: Raw # (%)
Main Functions	3-words	4-words	5-words	6-words	7-words	8-words
Case-related	160 (59.26%)	78 (54.93%)	43 (70.49%)	25 (80.65%)	1 (100%)	1 (100%)
Diagnosis & Intervention-related	74 (27.41%)	44 (30.99%)	12 (19.67%)	5 (16.13%)	0%	0%
Discourse Organizers	39 (14.44%)	19 (13.38%)	7 (11.48%)	1 (3.23%)	0%	0%
Grammatical only	10 (3.70%)
Stance & Engagement	12 (4.44%)	5 (3.52%)	3 (4.92%)	0%	0%	0%

Bundle length	Description (medical condition)	Description (subject)	Location (time/ place)	Quantification
3-word	48.13%	16.88%	23.75%	11.25%
4-word	46.15%	21.79%	19.23%	12.82%
5-word	34.88%	44.19%	18.28%	4.65%
6-word	64%	28%	4%	4%

Bundle lengths	Results Reporting	Procedure	Decisions/Outcome
3-word	40.54%	33.78%	25.68%
4-word	45.45%	29.55%	25%
5-word	41.67%	25%	33.33%

location_on

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[TFN1] Source: Adapted from Gray (2015).

MRAC
3-word	4-word	5-word	6-words	7-word	8-words	11-words
362	116	40	11	1	1	1
MCRC
3-word	4-word	5-word	6-words	7-word	8-words
270	142	61	30	1	1