Johnson

MeSH, LCSH, and Lupus Foundation of America: Subject Headings and Usability

Jayme Johnson

LI804XA

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MeSH, LCSH, and Lupus Foundation of America: Subject Headings and Usability

Lupus is an autoimmune disease with references in history dating back to the

classical era. Known for its variations in symptoms, including skin, joint, and organ

involvement, it has recently been separated into 4 main groups used for diagnosing

individuals; cutaneous (or discoid), systemic, neonatal, and drug-induced. For this

paper, I will be focusing on the LCSH, MeSH and online references to Systemic

Lupus Erythematosus or SLE. The identification of a type of Lupus that affects the

entire body, or systemic Lupus, was first categorized in the Neoclassical era around

the early 1870’s by Moriz Kaposi who realized that there could be two different

variations, cutaneous and systemic (Hochberg, 2003). By the mid-1900’s there was

a surge of research on the topic and many new discoveries, including treatment and

testing procedures. So far there is no known cure for Systemic Lupus Erythematosus.

The goal of this paper will be to analyze the subject heading systems of both

the National Library of Medicine and the Library of Congress. The MeSH system is a

“comprehensive controlled vocabulary for the purpose of indexing journal articles and

books in the life sciences; it can also serve as a thesaurus that facilitates searching”

(Medical Subject Headings). Created in 1960, I will examine the history of MeSH and

look at how this system manages the category of Lupus. LCSH is much broader

subject heading system and created in the late 19th/ early 20th century, from here I will

try to map the introduction of Lupus into the LCSH system and look at its evolution. In

addition to the subject heading systems, the Lupus Foundation of American runs a

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site to help educate patients and their families. The site, Lupus.org, has an extensive

collection of research and information on the disorders known as Lupus. By looking at

the website I will introduce the idea of “folksonomies” or user-created tags and data

and examine the possibility of such data to make subject heading easier to navigate

and more useful.

Created in 1898, Library of Congress Subject Headings are one of the most

widely used subject heading systems used in the United States. Although popular

today in all sizes of libraries, whether they are public, special, or academic, the LCSH

was originally thought to be the most useful for the university and only the largest of

public libraries with small public libraries using ALA List and Sears List of Subject

Headings to sort their collections (Stone, 3). This all changed in the 1930’s, many

libraries began the conversion from their own subject headings lists and converted to

LCSH, for several factors, all of which remain selling points for LCSH today. The

Library of Congress maintains their list of subject headings and is continually revised

to include new subjects and topics and it would be economically improbable for small

libraries to constantly be updating their subject catalogs at the same rate as the

Library of Congress (Stone, 4).

But with the ease of convenience of the LCSH system came disadvantages.

Although it became easier and easier for smaller libraries to update their catalogs

with the most up-to-date subject headings, many eventually complained that the

wording of some terms was biased or used language that was discriminatory. As the

times changed and accepted terminology did as well, by the 60’s and 70’s, there was

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the first of many attempts to remove some of this biased language (Stone, 5).

Another obvious disadvantage is lack of control from the librarians and the

subsequent reliance of the Library of Congress to create the proper subject headings

for the materials being cataloged. But overall the ease of use and the ability to

standardize the searching of headings throughout the majority of the United States

has been a huge selling point in the adoption of the Library of Congress subject

headings.

Another very important subject heading system is MeSH, created in 1960 by

the National Library of Medicine. Originally based off of a 1954 Armed Forces

Medical Library Subject Heading Authority list, the NLM created a list of 3,800

descriptors and 67 topical subheadings to be used in indexing and cataloging. Unlike

the LCSH system, MeSH focuses on only medical or health related sciences. The

MeSH system is one of the most popular subject heading systems in use today in

medical or health related libraries. Early in its history, the MeSH system underwent a

major change (eventually recognized to be a misstep), in the 1963-65 editions of

MeSH the subheadings were completely removed in an effort to streamline the

system. After an uproar about their disappearance, the subheadings returned and are

still available to this day (Schulman, 2010).

Similar to the Library of Congress subject heading system, the MeSH system

has had its share of detractions and setbacks. As mentioned above, in an attempt to

streamline the cataloging process by limiting subheadings to 10 major areas they

were removed. But they were quickly returned and today there are over 80 difference

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subheadings available. Another additional problem can be the specific subject matter

of the system. The majority of medical and health related libraries currently use

MeSH as their system of subject headings approximately 76% of libraries in

responded to a study in 1975 that they use MeSH with only 22% using LCSH. More

recent studies have concluded there is a mix of difference strategies for types of

subject headings systems and cataloging systems used in special subject libraries,

such as health sciences libraries (Womack, 105). The basic problem in limiting a

library to one subject heading system is simple, patrons of a health sciences library

may need information outside of the health sciences field. In an attempt to remedy

this problem some medical libraries are currently supplementing MeSH with LCSH

(Womack, 108).

Now that we’ve examined the history of both MeSH and the LCSH systems,

we need to look at how the term Lupus and more specifically Systemic Lupus

Erythematosus is cataloged within each system and explore if there are any

differences between the two. While MeSH is a system for organizing subject

headings for medical and health related libraries there are several difference ways to

access their system. One of the easiest ways is through the National Library of

Medicine’s website. Another popular access point is MEDLINE’s searchable

thesaurus.

The results for a basic search of “Lupus” in the National Library of Medicine’s

online subject heading search system yields many different terms that would be

applicable (see Figure 1). To further narrow the search down to the specific Systemic

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Lupus Erythematosus, a search of Systemic Lupus yields the result. Systemic Lupus

Erythematosus is references in MeSH as “Erythematosus, Systemic Lupus” and by

examining the expanded concept view of the subject any researcher can conclude

that there is several other variations that are acceptable including, Systemic Lupus

Erythematosus and Lupus Erythematosus Disseminatus. Also noted is several

concepts that are related to the systemic lupus, which include Antiphospholipid

Syndrome and Libman-Sacks Disease (see Figure 2).

MEDLINE is an online database that accesses several difference medical

journals and articles, including Index Medicus and International Nursing Index. As a

way of examining this database, the articles can be searched by the Library of

Congress Subject Headings. While some areas are not as detailed, one benefit is the

ability to see a list of qualifiers spelled out instead of just a list of abbreviations (see

Figure 3).

As expected the Library of Congress Subject Headings also has several

locations were one can look up the needed information on their topic. And although

many libraries may own the official publication set of the Library of Congress Subject

Headings (also commonly known as the “Red Books”), one of the easiest ways to find

the correct subject headings is to search on-line. Two of the most common search

sites are the Library of Congress Authorities Listing and FirstSearch OCLC also

known as WorldCat (see Figure 4). While WorldCat provides the basic information,

understandably it is the Library of Congress Authorities listing that is the most

complete (see Figure 5).

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As mentioned in the beginning of this paper, the lupus disorder has been

recognized for hundreds of years. As a subset Systemic Lupus was first described in

the late 1800’s most likely making it a recognized disorder by the time the Library of

Congress publish its first list of Subject Headings. In an attempt to map the

permutations in the Subject Headings of this disorder, I examined the Library of

Congress’s authority on Systemic Lupus. After speaking with a gentleman from the

Library of Congress, we were able to possibly determine this records date by looking

at the LC Control Number (b85078942) which would make the record’s creation date

1985), sometime after the discovery of the disorder (personal communication, April

28, 2012). Even more interesting was the information that the Library of Congress

does not regularly track that information, meaning even though 1985 seems to be an

incorrect establishment date for this record the only way to confirm any changes

would be to go through past Library of Congress Subject Heading books individually

to record any changes.

The MeSH system is similar in its overall layout, similar keywords are used

and the alternate names by which it is known is also the same. The differences

between MeSH and the LCSH come from the amount of information that is given in

the expanded version of the record. The MeSH system indicates the creation date

and the dates of when additional information or terms were added. For example in

Figure 2, the original subject heading, “Lupus Erythematosus, Systemic” is marked

that it was created in 1999. After speaking with Stuart Nelson, the head of the MeSH

department at the National Library of Medicine, he responded that the 1999 date is a

default for the system to indicate that the record has been in the system since the

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creation of MeSH in 1960 (personal communication, April 3, 2012). More information

comes from the list of secondary terms and concepts; here you are able to see the

evolution of the disorder and the research on it. On March 30th, 1974 Libman-Sacks

Disorder (an inflammatory process of the heart) was linked to the System Lupus

record and on December 31st, 1986, “Systemic Lupus Erythematosus” was

recognized as an alternate term. This mapping gives MeSH users a nice view of the

progression of the disorder via Subject Heading records.

But library searches and subject heading lists are not the only places people

can gather information about medical disorders, as the world becomes more and

more internet dependent, people are also becoming more likely to search for

information (medical or not) via the web. One of the most reliable sources for Lupus

information via the web is the Lupus Foundation of America (www.lupus.org) and one

of the most common ways to research is via keyword search on an internet search

engine like Google.com. But are you able to get enough information from these

searches and is it all correct? How does Lupus.org organize their information area

and could MeSH and LCSH learn from its accessibility?

Lupus Foundation of America is the premier institution for Lupus advocacy and

research information. Unlike Library of Congress and the National Library of

Medicine, the Lupus Foundation of America is not a library based organization and

they do not categorize their information with subject headings. Instead, the lupus.org

site is more user-oriented and contains only a search bar that allows for keywords

searches. If the user is unsure of what they may be looking for the website also has a

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section dedicated solely to education. Here, the information is separated into topics

including; Understanding Lupus, Diagnosing Lupus, Treating Lupus. But what does

this have to do with the LCSH and MeSH? Although Lupus.org is not a library

system, users may find its style of searching and organization much more familiar

and may be more likely to use a system that relies one keywords searches versus

subject headings. Recent evidence shows that keyword searching alone does not

gather all the data that could be useful or brings back results that do not quite fit. For

example, searching for “Systemic Lupus” keyword in the Emporia University Library

catalog brings back a total of 12 hits but several of the results seem unrelated to the

Lupus disorder. On the other hand if I search the Subject Headings for it limits the

results to just 8, all of which seem highly relevant.

So how do we bridge this gap between the decades old traditions of subject

heading searches and the more modern art of keyword searching? Subject headings

are efficient but clunky and keywords are easy and quick but unreliable. The answer

may be an emerging in the form of a new technique originating from blogs and types

of websites that have users creating large amounts of data or photos.

Folksonomies are “user-generated categorization and labeling” primarily found

on websites such as LibraryThing.com, blogs, and bookmarking services like

del.icio.us (West, 58). Users have access to content on the website and are allowed

to “tag” the information with keywords and phrases that describe that work and help

categorize it (West, 58). As a user reads or creates content on these types of

websites, they are allowed to post descriptors about it. These tags are not limited

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only to content but could express ideas or themes that are relatable only to that

specific user, such as the terms “read” or “to read” indicating to that person details

about that article. User created tags are also links, so if one user tags an item with a

specific title it links to all items tagged the same way. Although currently headings

and subject assigning are done exclusively by professional catalogers, the popularity

of tagging system on the internet have had professionals questioning the usefulness

of these types of tagging systems.

Current research is being done to look at how these user-generated tags could

be useful in a library setting. One website, LibraryThing.com, currently uses the

system to tag books added to personal libraries. The tags are used by members of

the site to organize their collections and to aide in finding new books tagged with the

same information. Some researchers believe that user-generated tags in library

catalogs would create a sense of ownership and pride in the local libraries and

because of the ease of use, help patrons navigate the cataloging system without

having to learn complicated subject headings (Rolla, 175).

On the other hand, drawbacks to the system are complicated as well. Since

the system is user-generated there are some areas of weakness that could

undermine its usefulness. Since the terms are generated by a large group of

untrained people, tags and labels created for the content would be uncontrolled. For

example, one individual may tag an article about Systemic Lupus with “Systemic

Lupus Erythematosus” while another may only put “Systemic Lupus.” Also, since tags

are un-moderated there is the possibility of user-abuse and purposeful mis-tagging of

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articles. But even with these drawbacks, many librarians and catalogers are

beginning to see possibilities in introducing Folksonomies into the cataloging process.

Indeed, user-generated tags would by no means replace the current subject headings

system but instead it would be added to the system in an attempt to make searching

easier for the patrons while engaging users to create tags.

Users are becoming more and more accustomed to keyword searching and

less familiar with subject headings. As shown from the two different types of subject

headings systems, finding the correct wording for a topic can be confusing and if the

incorrect heading is used your results could be significantly less or off topic. The

Lupus.org website does not currently take advantage of user tagging systems,

instead choosing to base its searching around keyword searches. By introducing

tagging into their system, topic searching could be more streamlined. Looking at the

past changes to Systemic Lupus Erythematosus subject headings and the other

topics and concepts associated with it, it is easy to see how information could get lost

in the search process. If I am a user who doesn’t take advantage of, or doesn’t

understand subject headings much of the information available could missed by just

using keyword searching. The future of library searching will most likely come from a

combination of subject headings searches and user-generated tags. User-generated

tagging will provide the patrons with more of a say on terms used to describe

subjects and help bridge the gap between library professionals and library patrons.

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References

Field, H. G. (1942). Subject Headings and the Growing Library. Bulletin of the

Medical Library Association, 30(4), 361–367.

Fikar, C. (n.d.). Making Sense of of Autoimmune and Rheumatic Disorders at the

Reference Desk. Medical Reference Services Quarterly, 22(4), 13–19.

Gault, L., Shultz, M., & Davies, K. (2002). Variation in Medical Subject Headings

(MeSH) mapping: from the natural language of patron terms to the controlled

vocabulary of mapped lists. Journal of the Medical Library Association, 90(2),

173–180.

Hochberg, M. C. (2003). The History of Lupus Erythematosus. The Lupus Foundation

of America.

http://www.lupus.org/webmodules/webarticlesnet/templates/new_aboutintrodu

ction.aspx?articleid=1520&zoneid=9

Jensen, J. B. (2010). Folksonomies for Digital Resources. PNLA Quarterly, 74(3),

23–38.

Lupus Foundation of America. (n.d.). http://www.lupus.org/newsite/index.html

McElfresh, L. K. (2008). Folksonomies and the Future of Subject Cataloging.

Technicalities, 28(2), 3–6.

McGregor, B. (2005). Constructing a consise medical taxonmy. Journal of the

Medical Library Association, 93(1).

Medical Subject Headings. (n.d.). http://www.iva.dk/bh/lifeboat_ko/specific

%20domains/medical_subject_headings.htm

Johnson, 13

Medical Subject Headings (MeSH) - Pallipedia. (n.d.). http://pallipedia.org/term.php?

id=541

Medical Subject Headings: Main headings, Subheadings, and Cross references used

in the Index Medicus and the National Library of Medicine Catalog. (1960).

Digital Library Collections.

http://www.nlm.nih.gov/hmd/collections/digital/MeSH/mesh.html

National Library of Medicine - Medical Subject Headings. (n.d.).National Library of

Medicine - Medical Subject Headings: Lupus.

http://www.nlm.nih.gov/cgi/mesh/2012/MB_cgi

Nelson, S. (personal communication, April 3, 2012).

Olson, T. (n.d.). LCSH to MeSH, MeSH to LCSH. Cataloging & Classification

Quarterly, 46(4), 431–446.

Rolla, P. J. (2009). User Tags versus Subject Headings: Can User-Supplied Data

Improve Subject Access to Library Collections? Library Resources & Technical

Services, 53(3), 174–184.

Ruffner, M., & Glenn, E. (2009). Highly Subjective: The Librarianship of Winfred

Sewell. Libraries & the Cultural Record, 44(2), 256–275.

Schreier Hallett, K. (1998). Separate but equal? a system comparison study of

MEDLINE’s controlled vocabulary MeSH. Bulletin of the Medical Library

Association, 86(4), 491–495.

Schulman, Jacque-Lynne. History of MeSH. (2010).

http://www.nlm.nih.gov/mesh/mesh_at_50/history_of_mesh.html

Stone, Alva T. (2009). The LCSH Century: A Brief History of the Library of Congress

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Subject Headings, and introduction to the Centennial Essays. Cataloging &

Classification Quarterly. 29(1-2), 1-15.

Suster, M. (2006). Folksonomy. AIIM E-DOC, 20(6), 20–21.

Thirion, B., & Darmoni, S. (1999). Simplified access to MeSH tree structures on

CISMeF. Bulletin of the Medical Library Association, 87(4), 481–481.

West, J. (2007). Subject Headings 2.0: Folksonomies and Tags. Library Media

Connection, 25(7), 58–59.

Williamson, D. (personal communication, April 28, 2012).

Womack, K. (2006). Conformity for Conformities Sake? The Choice of a

Classification System and a Subject Heading System in Academic Health

Sciences Libraries. Cataloging & Classification Quarterly, 42(1), 93–115.

Johnson, 15

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Figure 1. Search of the term Lupus using the National Library of Medicine MeSH. Available at http://www.nlm.nih.gov/mesh/MBrowser.html

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Figure 2. National Library of Medicine Expanded Concept View for Erythematosus, Systemic Lupus. Available at http://www.nlm.nih.gov/cgi/mesh/2012/MB_cgi?

mode=&index=7831&view=expanded

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Figure 3. MEDLINE’s Medical Subject Heading Listing for Systemic Lupus.

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Figure 4. OCLC or WorldCat subject headings.

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Figure 5. Library of Congress Subject Heading for Systemic Lupus Erythematosus. Available at http://authorities.loc.gov/cgi-bin/Pwebrecon.cgi?

AuthRecID=4729565&v2=1&HC=2&SEQ=20120503102632&PID=MxylOrJcIO-4AgW7Bn2W_7FkHI5-A