{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T05:54:40Z","timestamp":1769579680754,"version":"3.49.0"},"reference-count":13,"publisher":"Oxford University Press (OUP)","issue":"1057","license":[{"start":{"date-parts":[[2013,8,9]],"date-time":"2013-08-09T00:00:00Z","timestamp":1376006400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2013,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The time-honoured mnemonic of \u20185Fs\u2019 is a reminder to students that patients with upper abdominal pain and who conform to a profile of \u2018fair, fat, female, fertile and forty\u2019 are likely to have cholelithiasis. We feel, however, that a most important \u2018F\u2019\u2014that for \u2018family history\u2019\u2014is overlooked and should be introduced to enhance the value of a useful aide memoire.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>To assess the usefulness of each of the existing factors of a popular mnemonic, 398 patients admitted with upper abdominal pain between March 2009 and April 2010 were studied. The clinical features expressed in the cholelithiasis mnemonic in patients with sonographic evidence of cholelithiasis were compared with those of patients without.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Findings<\/jats:title>\n                  <jats:p>In the cholelithiasis group, significantly more patients were women (150\/198 (75.8%) vs 111\/200 (55.5%), p&amp;lt;0.001), fair (144\/198 (62.9%) vs 54\/200 (32.1%), (p&amp;lt;0.001)), fertile (135\/198 (68.2%) vs 50\/200 (25%) (p&amp;lt;0.001)) and had a body mass index &amp;gt;30 (56\/198 (28.3%) vs 19\/200 (9.5%) (p&amp;lt;0.001)) compared with controls; but age over 40\u2005years did not predict cholelithiasis (82\/198 (41.4%) vs 79\/200 (39.5%) (p=0.697)). In the cholelithiasis group, 78\/198 (39.4%) had a family history in at least one first-degree relative, compared with 27\/200 (13.5%) of controls, (p&amp;lt;0.001). Where the phenotypic elements of the history existed in combination, that patient was found to be at an increased risk of cholelithiasis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Interpretation<\/jats:title>\n                  <jats:p>Our study found that the validated \u2018students\u2019 5Fs\u2019 mnemonic retains a role in clinical diagnosis of patients suspected of cholelithiasis but the factor \u2018familial\u2019 should be substituted for \u2018forty\u2019 in recognition of the role of inheritance and the changing demographics of gallstone incidence.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/postgradmedj-2012-131341","type":"journal-article","created":{"date-parts":[[2013,8,10]],"date-time":"2013-08-10T04:38:03Z","timestamp":1376109483000},"page":"638-641","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":15,"title":["Validating the 5Fs mnemonic for cholelithiasis: time to include family history"],"prefix":"10.1093","volume":"89","author":[{"given":"Gary","family":"Bass","sequence":"first","affiliation":[{"name":"Royal College of Surgeons in Ireland Academic Department of Surgery, Connolly Hospital , Dublin, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S Nadia S","family":"Gilani","sequence":"additional","affiliation":[{"name":"Royal College of Surgeons in Ireland Academic Department of Surgery, Connolly Hospital , Dublin, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas N","family":"Walsh","sequence":"additional","affiliation":[{"name":"Royal College of Surgeons in Ireland Academic Department of Surgery, Connolly Hospital , Dublin, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frank","family":"Leader","sequence":"additional","affiliation":[{"name":"Royal College of Surgeons in Ireland Academic Department of Surgery, Connolly Hospital , Dublin, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2013,8,9]]},"reference":[{"key":"2023041906253851300_bib1","doi-asserted-by":"crossref","first-page":"1065","DOI":"10.1111\/j.1445-2197.2008.04752.x","article-title":"Surgical heuristics","volume":"78","author":"Patkin","year":"2008","journal-title":"ANZ J Surg"},{"key":"2023041906253851300_bib2","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1136\/emj.2003.012377","article-title":"Educational psychology in medical learning: a randomised controlled trial of two aide memoires for the recall of causes of electromechanical dissociation","volume":"21","author":"Dyson","year":"2004","journal-title":"Emerg Med J"},{"key":"2023041906253851300_bib3","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1097\/00006223-199703000-00013","article-title":"Unleashing the power of memory. 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