The change (...care -> ...medicine) happens after the first five words so it depends on whether you think it "changes the meaning of the title or indicates a different subject matter" with an in case of doubt leaning towards considering the change minor.

Unless the US ISSN Center decides it's a major change (and assigns a new ISSN), I would consider minor.  If you look at the LCSH for 'Palliative treatment' (which really should be on this record) there are see references from  'Palliative care' and 'Palliative medicine.'  IMO, in this case where treatment, care and medicine and considered close enough to synonyms to not create separate subject headings, I would consider the change from 'care' to 'medicine' to be minor.

Steve Shadle/Serials Access Librarian  *****  shadle@u.washington.edu
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On Mon, 6 Apr 2009, Kemp, Rebecca wrote:

> Hi, all- would those experienced catalogers out there consider this a major title change, from _American journal of hospice & palliative care_ to _American journal of hospice & palliative medicine_?  OCLC #21269606 considers it a minor change, while several OCLC #s, including 57519500, consider it a major change.
>
> --Rebecca
>
> Rebecca Kemp
> Serials Coordinator Librarian
> W.M. Randall Library
> UNC Wilmington
> 601 S. College Rd.
> Wilmington, NC 28403
> phone (910) 962-7220
> fax (910) 962-3078
> kempr<at>uncw<dot>edu
>