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Use Of Medical Subject Headings For Cataloging - 2005

This section of the Introduction to MeSH includes instructions for the correct coordination of main headings and subheadings, and assignment of publication types for cataloging. Also included are instructions for medical catalogers on how to construct the traditional subject heading string no longer used on NLM's internal bibliographic records. The traditional subject heading string is reconstructed on records NLM distributes to bibliographic utilities and other licensees.


The Cataloging Section at NLM uses the Medical Subject Headings (MeSH) thesaurus for assigning subject headings to materials in all formats. Catalogers follow the same principles for application of MeSH in subject analysis as do indexers for journal article literature.

Catalogers use the most specific MeSH terms available to describe the subject content of an item. (See also Specific Headings vs. Broader Headings below.) A very general work may sometimes be described with a single MeSH term. Complex concepts are represented by pre-coordinated main headings when available. When an appropriate pre-coordinated term is not available in the MeSH vocabulary, the concept is represented by the coordination of two or more main headings, or by main heading and topical subheading combinations.

For example, a work on research in occupational therapy is represented by the two main headings OCCUPATIONAL THERAPY and RESEARCH, whereas research in nursing is represented by the pre-coordinated heading NURSING RESEARCH. A work on a heart-lung transplant is represented by the pre-coordinated term HEART-LUNG TRANSPLANTATION whereas a work on transplantation of cartilage is represented the coordination of the main heading CARTILAGE and the topical subheading transplantation.

Cataloging Annotations

Cataloger annotations are provided in instances when more guidance for consistent application of MeSH is needed. Annotations applicable specifically to cataloging are prefaced by the word "CATALOG." Nearly all other MeSH annotations apply equally to cataloging and indexing. Exceptionally, catalogers use disease manifestation concepts such as SIGNS AND SYMPTOMS, EYE MANIFESTATIONS, SKIN MANIFESTATIONS, etc., and a few other very general terms annotated "not used for indexing," which do not have a similar instruction for catalogers.

MeSH Headings

Specific Headings vs. Broader Headings

Catalogers assign the most specific heading or headings available to bring out the main focus of an item. If the work covers several specific topics, the cataloger will assign as many specific subjects from different MeSH trees as required by the content of the work. When more than three specific headings are needed that fall within the same MeSH tree structure, the cataloger assigns the broader heading.

Example: Use EYE DISEASES (C11) if the content deals with

Headings Not used in Subject Cataloging

There are three types of MeSH headings not used in subject cataloging.

  1. A group of broad, general main headings not used in indexing or cataloging (e.g., FOOD AND BEVERAGES); instead catalogers use the appropriate specific main heading or headings to cover the concepts. These headings are annotated "not used for indexing; CATALOG: do not use" or "not used for indexing or cataloging."

  2. A small group of check tags are not used in cataloging. Check tags are used by indexers on all articles to which they apply, to identify categories of research subjects (e.g., MALE, FEMALE), type of research, (e.g., IN VITRO) or other specific parameters of the subject content of an article. They are identified by the annotation "check tag only." Other similar terms (e.g., ANIMALS, HUMANS, CHILD) may be used either as check tags as indicated above, or as regular MeSH descriptors when they are a focal point of an item being indexed or cataloged. They are annotated "NIM as check tag." These terms are used in cataloging as needed. See also special instructions for Age Group Headings & PREGNANCY below.

  3. Corporate names and uniform titles for serial publications, databases, names of laws, etc., found in MeSH, are not used in cataloging. These types of headings are annotated "CATALOG: use NAF entry." Catalogers use the heading from the NLM Name Authority File.

Age Group Headings & PREGNANCY

Catalogers use age groups and PREGNANCY either as primary or secondary subject headings. They are used as primary subjects when they are the focal point (i.e., the age group is the focus of the psychological, sociological or social content) of an item. When they are used as secondary subjects, they serve to specify age or pregnancy in relation to other main headings or main heading and topical subheading combinations. On distributed records, they are used as topical subheadings attached to other main headings or main heading and topical subheading combinations.

Topical Subheadings

Catalogers, like indexers, use no more than three topical subheadings with any one main heading, except in very rare circumstances. For any item in which more than three subheadings seem to be needed with a single main heading, the cataloger applies the Topical Subheading Hierarchies in an attempt to reduce the number of qualifiers required.

For example, if an item discusses diagnosis, therapy, epidemiology, and mortality of a disease, the disease heading is repeated with each of the first three subheadings. The last subheading is not applied because it falls under epidemiology in the subheading hierarchy.

If an item substantively discusses many aspects of a topic, generally the main heading is used without qualification if the number of topical subheadings cannot be limited to three by applying the subheading hierarchies.

For a topical subheading to be used with a main heading it must be included in the allowable qualifier (AQ) list for that heading. See the Introduction to MeSH section: "Qualifiers." The list of "Topical Subheadings with Scope Notes and Allowable Categories" provides guidance for qualifying a main heading with a topical subheading by descriptor categories or subcategories. However, some exceptions to the general guidelines apply to specific terms. In the MeSH Browser, the MeSH unit record for each MeSH descriptor includes a complete list of allowable qualifiers valid for use with that descriptor.

Publication Types

The "Publication Types" section of the Introduction to MeSH includes the full list of publication types available for use with the MeSH vocabulary, as well as scope notes providing definitions of each term. One or more publication types may be assigned to an item to characterize the nature of the information presented (e.g., the item is a bibliography, handbook, outline, etc.)

The Introduction to MeSH section, "Publication Types-Scope Notes" supplies a list of all publication types available in the MeSH vocabulary. Not all available publication types are used by NLM catalogers. The publication types used in cataloging have been divided into two groups, the "List of Publication Types Used as Form Divisions" and the "List of Publication Types Used as Genres." This differentiation between like terms is made so that medical catalogers can add a publication type found in the first list as a form division to a subject heading string (MARC 21 650 subfield $v). It is entered in MARC 21 field 655 (Genre/Form) in LocatorPlus, NLM's online public access catalog. Publication types found in the second list are treated as genres and are not added to any subject heading string. They are entered in LocatorPlus field 659, a locally defined publication type field, and in MARC 21 field 655 on distributed records.

Note: Publication types which are not included in either list are not used by catalogers.

Publication Types used in MARC 21 field 655 in LocatorPlus and as form division in subfield $v of the 650 field on distributed records. The source code in $2 is "mesh." (See examples below.)

Case Reports
Collected Correspondence
Collected Works
Examination Questions
Juvenile Literature
Laboratory Manuals
Legal Cases
Nurses' Instruction
Periodical Index
Personal Narratives
Pictorial Works
Popular Works
Problems and Exercises
Programmed Instruction Resource Guides
Union Lists

in LocatorPlus
650 12 $a Kidney Diseases
655 _7 $a Congresses $2 mesh

On distributed records
650 12 $a Kidney Diseases $v Congresses

Publication Types used in field 659 in LocatorPlus and as genres in MARC 21 655 Genre/Form field on distributed records. The source code in $2 is "mesh." (See examples below.)

Note: Terms marked with an asterisk (*) are used primarily in cataloging historical materials and in bibliographic records created by collaborative partners.

*Academic Dissertations
Account Books
*Annual Reports
Architectural Drawings
Book Illustrations
*Book Reviews
Consensus Development Conference
Consensus Development Conference, NIH
*Documentaries and Factual Films
Evaluation Studies
*Fictional Works
Funeral Sermons
*Government Publications
Lecture Notes
Newspaper Article
Patient Education Handout
Practice Guideline
Price Lists
Retracted Publication
*Review, Tutorial
Review of Reported Cases
Scientific Integrity Review
Technical Report
*Unedited Footage
*Validation Studies


in LocatorPlus
650 12 $a Renal Dialysis
659 _7 $a Practice Guideline $2 mesh

On distributed records
650 12 $a Renal Dialysis
655 _7 $a Practice Guideline $2 mesh

Changes in Subject Heading Structure, Content and Practice

With the adoption of 1999 MeSH and the implementation of the Voyager Integrated Library System, the Cataloging Section moved to harmonize its practices for subject heading content and structure with NLM's indexing practices. These changes were intended to facilitate cross-file searching through the NLM Gateway and enhance retrieval by assuring that the same terms produce like results for articles, books, non-print materials, electronic resources, etc.

Structural and Content Changes

In NLM's Web-based catalogs1 main headings, or main heading and topical subheading combinations, are not qualified by geographic, form, or language. Instead geographic descriptors and publication types (PTs), previously known as form divisions, are carried in separate fields and are used in retrieval in coordination with main headings or main heading and topical subheading combinations. The LocatorPlus record does not contain language subfields in the subject string since this information is encoded in the MARC 21 language field (041).

Information about the physical format of an item is not part of the subject string. The descriptive and coded portions of a bibliographic record contain physical format information.

In the MARC View of LocatorPlus2 , subject headings appear in the following format:

650 _2 $a Main Heading $x topical subheading
651 _2 $a Geographic location $x topical subheading
655 _7 $a Publication Type ( formerly form division) $2 mesh
659 _7 $a Genre/publication type $2 mesh

Based on advice received from a number of medical libraries, NLM recombines subject headings, geographic descriptors and publication types to form the conventional subject heading string in MARC 21 records distributed to bibliographic utilities and other licensees. Language subfields are appended to the subject string on distributed records when one of the following publication types is used: DICTIONARY, ENCYCLOPEDIAS, PHRASES or TERMINOLOGY.

The order of the main headings and subheadings on distributed records is:

650 _2 ?$a Main heading $x topical subheading ?$z Geographic location ?$v Publication Type/genre [former form subheading] ?$x language
650 _2 $a Main heading ?$x topical subheading ?$x age group $z geographic location ?$v Publication Type/genre [former form subheading] ?$x language

Changes - 2005

The MeSH vocabulary terms for History of Medicine for specific time periods (e.g., HISTORY of MEDICINE, 15th CENT.) have been replaced by terms for history followed by the same time period (e.g., HISTORY, 15th CENTURY).

As of 2005:

  • For general works on the history of medicine in a specific time period, catalogers will coordinate the MeSH term HISTORY OF MEDICINE with the specific time period.

  • For works on the history of a specific topic discussed in a medical context, if history is not an allowable qualifier for the MeSH term assigned, catalogers will coordinate the MeSH term assigned with the MeSH term HISTORY OF MEDICINE and the term for the specific time period.

  • When history is an allowable qualifier for the MeSH term assigned, and when using pre-coordinated history terms such as HISTORY OF DENTISTRY, catalogers will coordinate the MeSH term assigned with the term for the specific time period, but will generally not also add HISTORY OF MEDICINE.


For a general history of medicine in medieval times:
650 12 $a History of Medicine
650 22 $a History, Medieval

For a work on the history of the health implications of parasitic organisms as they were understood in ancient times:
(History is not an allowable qualifier for the MeSH term PARASITES.)
650 12 $a Parasites
650 12 $a History of Medicine
650 22 $a History, Ancient

For a work on the history of obstetrical practices in the eighteenth century:
650 12 $a Obstetrics $x history
650 22 $a History, 18th Century

1NLM catalogs include the Web-based OPAC, LocatorPlus, as well as an Entrez-base search interface known as the NLM Catalog.
2LocatorPlus is the Web OPAC of Voyager, the integrated library system used at NLM.