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AMA 10th Referencing Guide: Clinical Decision Tools

Referencing guide for the 10th Edition for AMA Style

In text numbering

Superscript numbers

The numbers in text are in superscript1 and occur at the end of the clause in which you used the information.  They occur outside “quotation marks,”2 commas,3 (parentheses)4 and full stops.5 However, they occur inside semicolons6; and colons7:

Do not leave a space between the last letter or punctuation mark and the number.

Re-use numbers for the same citation

Citations should be numbered sequentially – that is, the first source you cite is 1, the second source is 2 and so on.

However, once you have given a source a number, it will keep that number throughout your paper. So, if you use your first source again, no matter how often you use it, it is still 1.

Citing more than one work at a time

Use commas to show that more than one work is being cited, and use hyphens for several works that would be numbered sequentially:

These side effects can have implications for the patient's mental health, as numerous studies have shown.1,3,6-9

Relationship between in-text citations and reference list

Your reference list follows the order of the numbers used in the text. The first source you cite in the text is 1 and the reader will look for number 1 in the reference list to find the full citation; the fifth source you use is 5 and the full citation is listed at number 5 in the reference list (and so on).

Using author's names in-text:

If including an author in the text of a sentence, use the surnames of authors and add the citation number after the author’s surname. 

  • For one or two authors list all names
    • Smith1 reported on the survey.
    • Smith and Watson2 reported on the survey.
  • For more than two authors list the first author and follow by et al
    • Smith et al3 reported on the survey. 

Clinical decision support tools

Use this if:

  • You are citing an entry in an online clinicians' decision support tool or evidence-based practice database.

You will need (minimum information in bold):

  • Author(s) (if available)
  • Entry title (in sentence case - not in italics)
  • Editor(s) (if available)
  • Database title (in Title Case - not in italics)
  • City of Publication and state abbreviation (if published in America) or country (if not published in America)
  • Publisher's name
  • Year of publication
  • URL
  • Updated date
  • Accessed date


Standard database pattern:


Author AA, Author BB. Title of entry [type of entry, if applicable]. In: Editor AA, Editor BB, eds (if available). Title of Database. City, State Abbreviation (if American) or Country of publisher: Publisher’s name; Year. URL. Updated date (at least year, if available). Accessed date.


  1. Dengue fever: pathophysiology. In: BMJ Best Practice. London, England: BMJ Publishing Group; 2015. Updated July 17, 2015. Accessed August 17, 2015.
  2. Pediculosis. In: ClinicalKey. Amsterdam, Netherlands: Elsevier; 2018. Updated November 13, 2018. Accessed August 5, 2019.

If you were referring to the database as a whole, rather than an individual entry in the database, you would skip the reference to the authors and title of the entry and begin with the Editors or "authors" (if there are any) of the database, if you can't find them (or they are the same as the title of the database) start with the title of the database.  Do not include an Updated date.

  1. Elsevier Point of Care. ClinicalKey. Amsterdam, Netherlands: Elsevier; 2019. Accessed August 17, 2019.


  • If there are no authors, begin with the title of the entry.
  • If you cannot find a place of publication, use the city in which the head offices of the company are located.
  • Due to the nature of clinical decision tools, an Updated date should always be acknowledged for pinpointed information (i.e. information from any given entry) - if you do not have a date last updated, use "Updated date unknown".  For references to the entire work, only the date of publication is required.

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