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2025 MeSH Update and PubMed Year-End Activities

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At the end of each year, the National Library of Medicine (NLM) produces their annual updates to PubMed’s MeSH (Medical Subject Headings). These changes are made at every level of the MeSH infrastructure, including descriptors (headings or terms), qualifiers (subheadings), and supplementary concepts, and are made in response to changes in scientific discovery, taxonomy, ethical considerations, and published literature. The National Library of Medicine describes the necessity of these changes as this: “In biomedicine and related areas, new concepts are constantly emerging, old concepts are in a state of flux and terminology and usage are modified accordingly. To accommodate these changes, descriptors must be added to, changed or deleted from MeSH with adjustments in the related hierarchies, the Tree Structures.”

Types of MeSH Changes

  • Added Terms — brand new terms added, either as MeSH headings or Supplementary Concepts that currently do not warrant a full heading
  • Modified Terms — MeSH concepts that were changed (either name or hierarchical location), also referred to the the “Preferred Term“
  • Replaced Terms — Descriptors or Supplementary concept terms are replaced by another term; this can include Supplementary Concepts upgraded to Descriptors as well as merged terms
  • Merged Terms — Multiple Descriptor or Supplementary concept terms combined under a single concept term
  • Combined Terms — Descriptor and Qualifier (subheading) combination made into a new separate concept
  • Deleted Terms — Descriptor or Supplementary concept terms removed, due to either being combined, upgraded, or renamed

What’s New in 2025

Artificial Intelligence

The 2025 Annual MeSH Update includes a variety of important and much-needed changes. One of the biggest and most needed expansions in the 2025 update is to the Artificial Intelligence concept, including dozens of new MeSH Descriptors found within the broader concept, including:

Publication types

Several changes were made to publication types for MeSH 2025, including two new publication types:

Note: The NLM has made an exception to their general rule of not retroactively indexing; so just as they did in 2019 when “Systematic Reviews” became a separate publication type, citations will be retroactively updated to reflect these two new publication types.

The Network Meta-Analysis publication type was previously a Descriptor (MeSH Heading); thus for existing citations, the Descriptor term (“Network Meta-Analysis”[MeSH]) will be replaced with either the “Network Meta-Analysis”[Publication Type] OR “Network Meta-Analysis as Topic”[Mesh] as appropriate. This is an important change, as it extends the scope of indexing the publication type back to the introduction of the original term in 2017.

The “Scoping Review”[Publication Type] will replace either the “Review”[Publication Type] or “Systematic Review”[Publication Type] on appropriate citations extending back to 2020, the first year this term appears in MEDLINE. Additionally, “Scoping Review as Topic”[Mesh] has been expanded from the “Review as a Topic”[Mesh] term.

Additionally, NLM will discontinue indexing following Publication Type terms:

Note: As with previously discontinued Publication Types, which include “Government Publication,” “Newspaper Article,” “Overall,” and “Scientific Integrity Review,” these Publication Types will continue to exist in MeSH, appear on existing citations, and be searchable in PubMed. However, they will no longer be applied to new citations.

How Does this Impact Searching?

Since there are so many changes to MeSH terms and structure, if you save search strategies or search alerts, or want to rerun a search that was previously conducted (such as from a systematic review), these changes may impact if and how your search strategy functions. Below are some steps to take to ensure that your search strategy is not only viable but also the best reflection of the current database.

  1. Check search viability — Run your search in PubMed and go to Advanced Search and check if there are issues being highlighted in the Details section. Terms that were removed or modified (name changed, upgraded, merged, etc.) will likely be in red. If your search is suddenly retrieving no results, this also could be the cause.
  2. Identify relevant new terms — Refer to the New MeSH Descriptors for 2025 list to see if there are any relevant terms that were added for 2025 that may make your search strategy more robust or specific.
  3. Identify replaced terms — Refer to the MeSH 2025 – Replace Report to identify any terms that were replaced by another term, upgraded to Descriptors, or consolidated with another term.
  4. Review publication types — Refer to the Annual MeSH Processing for 2025 NLM Bulletin for changes to publication types

If you have searches saved in your My NCBI account and/or you are getting PubMed e-mail alerts, or if you need to update your Systematic Review based on your previous search strategy, you may want to consult a Research Informationist to ensure your saved searches are not affected by the annual changes in the MeSH terminology. Don’t hesitate to ASK US!

Important Note from NLM Regarding Reindexing

Typically, the NLM does not retroactively re-index MEDLINE citations with new MeSH heading concepts. Therefore, searching PubMed for a new MeSH term tagged with [mh] or [majr] effectively limits retrieval to citations indexed after the term was introduced. Searchers may consult the MeSH database to see the previous indexing terms most likely used for a particular concept before the new MeSH heading was introduced. For terms without previous indexing information, consider the next broader term(s) in the MeSH hierarchy. or more searching guidance, see the on-demand class MeSH Changes and PubMed Searching.

Converting EndNote Citations to Unformatted Citations or Plain Text in Microsoft Word

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The citation management software EndNote allows authors to easily add references from their EndNote library directly into their manuscripts in Microsoft Word, and these citations can move and respond as changes are made within the document. This works by including behind-the-scenes code into the Word document that is able to “talk” to the EndNote library. However, because of this additional information within the Word document, it can cause issues when it tries to talk to an EndNote library, but that library is not available (e.g. on another person’s computer).

Thus, it’s important to be able turn off this functionality without removing all the citations that have already been added to a manuscript. There are a few different options to turn off this functionality, including both temporary and permanent options.

Unformatted Citations

Unformatted citations is a temporary method of turning off this talking between Word and EndNote. This option can be used during the active writing stage, where a manuscript might be shared amongst collaborators or across devices and these different parties are all editing the document. It also can be used in conjunction with regularly formatted citations, where some citations are actively formatted and some are converted to unformatted temporary placeholders in the document.

This method converts the in-text citations to plain text, but with language that can be read by EndNote. However, t’s not actively talking to EndNote. In this method the in-text citation information is stored within {curly brackets} as a placeholder, and at any time the document can be reformatted and the proper in-text citations and bibliography will once again be functional and talking to EndNote.

Since this option will add curly brackets with the citation information within, those whom the manuscript is shared with must understand to be careful not to delete or move this bracketed information. If there is a risk that a collaborator might accidentally manipulate this information, see the plain text option below. Collaborators can add additional text and references as plain text that can be added through EndNote later once the document is reformatted.

Unformatted citations can also be used when dealing with extremely large documents with hundreds of citations, that can become very slow. There is also an option to turn off automatic formatting, which only talks to EndNote when you explicitly tell Word to update the bibliography.

EndNote for Windows OS

On the EndNote 21 tab within Microsoft Word, go to Convert Citations and Bibliography, and select Convert to Unformatted Citations.

If you are unformatting the entire document, this unformats all of the in-text citations and removes the current bibliography.

If you want to remove formatting for a specific citation or section, simply highlight that citation or section and then select Convert to Unformatted Citations.

EndNote for Macintosh OS

On the EndNote 21 tab within Microsoft Word, go to Tools, and then select Convert to Unformatted Citations.

If you are unformatting the entire document, this unformats all of the in-text citations and removes the current bibliography.

If you want to remove formatting for a specific citation or section, simply highlight that citation or section and then select Convert to Unformatted Citations.

Plain Text Citations

Plain text citations or Removing Field Codes is a permanent method of disabling the behind-the-scenes code that allows the Word document to communicate with EndNote. Since this method is permanent, it should be done after the active writing stage, and when the document needs to be sent to a publisher, editor, or outside reviewer.

Converting citations to plain text means stripping all metadata associated with EndNote from the Word document, and the in-text citations and bibliography are turned into regular Word document text.

This option can also be used during the writing process, if for example, there is a fear or risk of collaborators accidentally manipulating the information within the curly brackets of the unformatted citations, or if the curly brackets create a difficult reading environment. It can also be used if for some reason a reference has formatting errors that cannot be corrected through EndNote and need to be fixed manually.

Since this method is permanent, Word prompts you to save the plain text as a separate copy, so there is always a fail-safe if changes need to be made there is still a version that is connected to EndNote.

EndNote for Windows OS

On the EndNote 21 tab in Microsoft Word, go to Convert Citations and Bibliography, and select Convert to Plain Text. Click OK in the confirmation dialog to create a new document. A copy of the document, without field codes, appears in a new document window.

EndNote for Macintosh OS

On the EndNote 21 tab in Microsoft Word, go to Tools, and select Convert to Plain Text. Click OK in the confirmation dialog to create a new document. A copy of the document, without field codes, appears in a new document window.

Cochrane Library Keyword Search

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Cochrane Library is a collection of databases produced by the Cochrane Collaboration, that include Cochrane Systematic Reviews, Cochrane CENTRAL Register of Controlled Trials, and more.

Although Cochrane Library offers a MeSH search functionality, many searchers use just keyword searching so that not to duplicate the effort if they’ve already searched with MeSH in Pubmed or with Emtree terms in Embase (these 2 databases are major sources of Cochrane CENTRAL content).

There are four main ways to search Cochrane Library using keywords. The main difference between these four types of keyword searches is what is going on behind the scenes and how much control is given to the user in creating their search.

Basic Search

Cochrane’s most basic search is the search bar found on their homepage. It defaults to searching title, abstract, and keyword – however it gives little ability to modify searches or create comprehensive search strategies.

This search should only be used for the most basic and general searches, and not for conducting any type of literature review search.

The basic search also offers users to browse pre-set topics. These topics will automatically execute search on that topic to find Cochrane Reviews and Review Protocols, but it will not include results found in Trials.

Once a search is conducted using the basic search bar, the results are immediately displayed but also, the search string will appear within the advanced search page and the options below will become available for searches going forward.

Search Tab

The Search tab can be found by clicking on Advanced Search on the Cochrane homepage, just under the basic search bar; this takes you to the advanced search tabs. The main Search tab allows for more control of how and what is searched.

First, it allows for multiple search lines (that can be combined with Boolean operators), so you can combine multiple terms/concepts together easily. By clicking on the + it adds a new search box and from there you can identify what Boolean operator (AND, OR, NOT) you wish to use to combine the terms.

The advanced search tab also allows users to search a specific field (as opposed to just title/abstract/keyword). It also has search limit ability, to focus results by publication date or content type.

The one limitation of the search tab is it has limits on the length of search string used, similarly to basic search. The solution is to select Send to Search Manager instead of clicking Run Search.

Search Using Word Variations

One benefit of using the Search Tab (as compared to using the more functionally complex Search Manager), is that searches conducted in this tab are searched with word variations (except for the truncated terms), based on a Cochrane algorithm. In these instances, the Cochrane Library provides a note after the search string: (Word variations have been searched).

For example, if you search on “artificial intelligence” the algorithm will also include the phrase “artificially intelligent” to your search strategy. If you want to include these word variations in a complex search in Search Manager you must use the Search tab and then send the executed search to Search Manager to be included in your larger search strategy.

Search Manager will then format that search by enclosing it in parentheses and adding the field codes that were selected in the search tab (ex. ti,ab,kw) followed by the note (Word variations have been searched).

NOTE: Since word variations are ONLY added when the search is initiated from the Search tab, results will differ if the same search strategy is run in the Search tab as opposed to Search Manager. See example below to understand how results can differ in different circumstances:

Start from Search Tab
1. Enter terms and run search:
          breast cancer AND hormone therapy

Results: 7,643 (split between Cochrane Reviews: 45 and Trials: 7,596)


2. Enter terms and send to search manager:
          breast cancer AND hormone therapy

What is returned:
     (breast cancer AND hormone therapy):ti,ab,kw
     (Word variations have been searched)

Results: 7,643

----------------------------------------------------------------------

Start from Search Manager
1. Enter terms and run from Search Manager:
     breast cancer AND hormone therapy

Results: 5,772

2. Enter terms and run from Search Manager:
     (breast cancer AND hormone therapy):ti,ab,kw

Results: 5,412

Search Manager

The Search Manager is located within the Advanced Search tabs. Search Manager allows users to create and save complex multi-line searches. It supports the use of MeSH terms, logical operators, field labels, nesting, and wildcards. It also allows for unlimited search lines, and results can be viewed by search line (helpful to determine where issues might be in a strategy).

The search manager also allows for combining search lines by using their number (e.g. #1 AND #2; #1 OR #2) instead of the full content of each line, which can save time and space. It also can make it easier to see where and how concepts are being combined when developing complex searches.

Searches conducted in the search tab can be sent to search manager, The search manager is necessary for conducting and saving complex searches, especially those for large literature reviews and systematic reviews. The search manager is the only type of search in Cochrane Library that allows capturing your search history – for that you need to click Print search history icon.

In order to save searches you have to be signed in your account from within your institutionally subscribed to Cochrane Library (Sign in is located in the right upper corner of the Search Manager Screen). Registering for an account allows you to set up email alerts based on your searches.

The Medical terms (MeSH) tab can also be used to search for relevant MeSH terms to add to your search, and then sent to the search manager.

PICO Search

The last advanced search tab is the PICO search which allows users to build a search according to the PICO framework (population, intervention, comparison, outcome). When using the PICO search as you type in search terms it will identify the specific “PICO vocabulary” that is relevant. This is necessary when using the PICO search as it will direct the terms to the specific PICO concept.

Other Search Functionalities in Cochrane

Boolean Operators

As in most online databases, Cochrane Library allows for users to search and combine terms using the Boolean Operators: AND, OR and NOT.

Exact Phrases

If you are searching for exact phrases, they should be enclosed in double quotations.

Proximity Operators

Cochrane Library allows for the use of Proximity operators, including: NEAR, NEAR/X and NEXT. Finds terms within close proximity to each other in the article or field(s) being searched.

NEAR
Finds the terms when they are within 6 words of each other. Terms can appear in either order.

cancer NEAR lung

Finds "lung cancer" and "cancer in the patient's lung"

NEAR/X
Finds the terms when they are within X words of each other where X = the maximum number of words between search terms. Terms can appear in either order.

cancer NEAR/3 lung

Finds "lung cancer" and "cancer of the lung", but NOT "cancer in the patient's lung"

NEXT
Finds the terms when they appear next to each other. Terms must appear in the order specified. Use the NEXT operator for phrase searching with wildcards.

cancer NEXT lung

Finds "lung cancer" but not "cancer of the lung" or "cancer in the patient's lung"

Truncation & Wildcards

Truncating a word means using a wildcard (*} which allows retrieving results with various ending of the word after truncation.

Do not use double quotes with truncation (*) anywhere in Cochrane Library searches, as truncation is ignored by Cochrane Library if used within double quotes. To overcome this, use the NEXT operator to search for an exact phrase with truncation.

Ex: instead of "heart transplant*" use (heart NEXT transplant*)

If you are interested in learning more about how to best use and search the Cochrane Library collection of databases, take a look at their e-books How to Search in Cochrane Library or Cochrane Library User Guide.