Questions From Users of the Manual

Q: If I have a title with a colon, is the first word after the colon capitalized or lowercased?

A: If you are speaking about title and subtitle on the manuscript itself, every major word in the title and subtitle, as well as the first word of title and subtitle, would begin with a capital letter.

Endless and Essential:  The Tug-of-War Over Off-Label Use

If you are speaking about the title and subtitle of a journal article as it appears in the reference list, only the first word of the title and any proper nouns would begin with a capital letter.

19. Incollingo J. Endless and essential:  the tug-of-war over off-label use. Cataract & Refractive Surgery Today. 2016;16(5):19-27.

More about capitalization of titles can be found in chapter 10.—Cheryl Iverson, MA

Quiz Bowl: To Capitalize or Not to Capitalize

Flipping through the table of contents of the most recent issues of JAMA and the Archives journals, I realize how challenging it can be to correctly capitalize article titles and subtitles. Do hyphenated compounds use initial capital letters on both terms? Are words of 2 letters or fewer capitalized? How do you capitalize genus and species names? Much like Hamlet’s “To Be or Not to Be” conundrum, I am often found muttering to myself “To Capitalize or Not to Capitalize.”

This month in the Archives of Internal Medicine, an article on hip fracture and increased short-term but not long-term mortality in healthy older women appears. But how should this be capitalized as a title? Is it “Hip Fracture and Increased Short-Term But Not Long-Term Mortality in Healthy Older Women,” “Hip Fracture and Increased Short-term But Not Long-term Mortality in Healthy Older Women,” or “Hip Fracture and Increased Short-term but Not Long-term Mortality in Healthy Older Women”?

This month’s JAMA contains an article on the need for critical reappraisal of intra-aortic balloon counterpulsation. But is it the “Need for Critical Reappraisal of Intra-Aortic Balloon Counterpulsation” or the “Need for Critical Reappraisal of Intra-aortic Balloon Counterpulsation”?

Finally, in the Archives of Otolaryngology–Head & Neck Surgery, an article on leiomyosarcoma of the head and neck: a population-based analysis is published. But did the authors perform “A Population-Based Study” or “A Population-based Study”?

Capitalizing titles can provide editors with a sea of troubles, which is why we have chosen the topic for this month’s quiz. Test your ability to correctly capitalize the title in the following example. For further explanation of the correct answer, refer to section 10.2 (pp 372-374 in print). Then check out this month’s quiz (which subscribers can find at for more titles and subtitles to capitalize.

tolcapone in patients with parkinson disease: a randomized, double-blind, placebo-controlled trial

Okay, back to the original question—to capitalize or not to capitalize? How did you handle this title and subtitle? Did you know that double-blind and placebo-controlled are treated differently? Here’s the answer (use your mouse to highlight the text box):

Tolcapone in Patients With Parkinson Disease: A Randomized, Double-blind, Placebo-Controlled Trial

The A should be capitalized because it is the first word of the subtitle (§10.2, Titles and Headings, p 372 in print). Double-blind is a hyphenated compound considered a single word (ie, it can be found as a single entry in Webster’s); therefore, blind should not be capitalized. Placebo and controlled are 2 separate terms operating together as a temporary compound; therefore, both parts of the hyphenated compound should be capitalized (§10.2.2, Hyphenated Compounds, pp 373-374 in print).

For the record, those titles I mentioned earlier should be capitalized as follows:

Hip Fracture and Increased Short-term but Not Long-term Mortality in Healthy Older Women
Need for Critical Reappraisal of Intra-aortic Balloon Counterpulsation
Leiomyosarcoma of the Head and Neck: A Population-Based Analysis

If you want more examples to help you solve the puzzle surrounding correct capitalization of titles and subtitles, take the Capitalization of Titles and Subtitles Quiz on the AMA Manual of Style online.—Laura King, MA, ELS