Development of an International Odor Identification Test for Children: The Universal Sniff Test

doi:10.1016/j.jpeds.2018.03.011

Multicenter Study

. 2018 Jul:198:265-272.e3.

doi: 10.1016/j.jpeds.2018.03.011. Epub 2018 May 2.

Development of an International Odor Identification Test for Children: The Universal Sniff Test

Valentin A Schriever¹, Eduardo Agosin², Aytug Altundag³, Hadas Avni⁴, Helene Cao Van⁵, Carlos Cornejo⁶, Gonzalo de Los Santos⁷, Gad Fishman⁸, Claudio Fragola⁷, Marco Guarneros⁹, Neelima Gupta¹⁰, Robyn Hudson⁹, Reda Kamel¹¹, Antti Knaapila¹², Iordanis Konstantinidis¹³, Basile N Landis¹⁴, Maria Larsson¹⁵, Johan N Lundström¹⁶, Alberto Macchi¹⁷, Franklin Mariño-Sánchez¹⁸, Lenka Martinec Nováková¹⁹, Eri Mori²⁰, Joaquim Mullol²¹, Marie Nord¹⁵, Valentina Parma²², Carl Philpott²³, Evan J Propst²⁴, Ahmed Rawan¹¹, Mari Sandell²⁵, Agnieszka Sorokowska²⁶, Piotr Sorokowski²⁷, Lisa-Marie Sparing-Paschke²⁸, Carolin Stetzler²⁸, Claudia Valder²⁹, Jan Vodicka³⁰, Thomas Hummel²⁸

Affiliations

¹ Smell and Taste Clinic, Department of Otorhinolaryngology, Medizinische Fakultät Carl Gustav Carus, Technische Universität, Dresden, Germany; Abteilung Neuropädiatrie, Medizinische Fakultät Carl Gustav Carus, Technische Universität, Dresden, Germany. Electronic address: valentin.schriever@uniklinikum-dresden.de.
² Escuela de Ingeniería, Pontificia Universidad Católica de Chile, Santiago, Chile.
³ Istanbul Smell and Taste Center, Istanbul, Turkey.
⁴ Pediatric Feeding Disorders clinic, Dana Children's Hospital, Tel Aviv Medical Center, Tel Aviv, Israel.
⁵ Pediatric Otolaryngology Unit, Department of Otorhinolaryngology, Head and Neck Surgery, University Hospitals of Geneva, Geneva, Switzerland.
⁶ Escuela de Psicología, Pontificia Universidad Católica de Chile, Santiago, Chile.
⁷ Unidad de Rinología y Cirugía de Base de Cráneo. Servicio de Otorrinolaringología. Hospital Universitario Ramón y Cajal. Madrid, Spain.
⁸ Pediatric Otolaryngology, Dana Children's Hospital, Tel-Aviv Medical Center, Sackler School of Medicine, Tel-Aviv, Israel.
⁹ Departamento de Biología Celular y Fisiología, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Mexico.
¹⁰ Department of Otorhinolaryngology, University College of Medical Sciences and GTB Hospital, Delhi, India.
¹¹ Department of Otorhinolaryngology, Head and Neck Surgery, Cairo University, Cairo, Egypt.
¹² Food Chemistry and Food Development, Department of Biochemistry, University of Turku, Turku, Finland; Department of Food and Environmental Sciences, University of Helsinki, Helsinki, Finland.
¹³ Otorhinolaryngology Department, Aristotle University, Thessaloniki, Greece.
¹⁴ Rhinology-Olfactology Unit, Department of Otorhinolaryngology Head and Neck Surgery, University Hospital of Geneva, Switzerland.
¹⁵ Gösta Ekman Laboratory, Department of Psychology, Stockholm University, Stockholm, Sweden.
¹⁶ Monell Chemical Senses Center, Philadelphia, PA; Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
¹⁷ ORL Clinica, Università of Insubriae Varese, ASST Settelaghi, Varese, Italy.
¹⁸ Unidad de Rinología y Cirugía de Base de Cráneo. Servicio de Otorrinolaringología. Hospital Universitario Ramón y Cajal. Madrid, Spain; INGENIO, Immunoal.lèrgia Respiratòria Clínica i Experimental (IRCE), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, CIBERES, Barcelona, Catalonia, Spain.
¹⁹ Department of Anthropology, Faculty of Humanities, Charles University, Czech Republic; National Institute of Mental Health, Klecany, Czech Republic.
²⁰ Department of Otorhinolaryngology, The Jikei University School of Medicine, Tokyo, Japan.
²¹ INGENIO, Immunoal.lèrgia Respiratòria Clínica i Experimental (IRCE), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, CIBERES, Barcelona, Catalonia, Spain.
²² Monell Chemical Senses Center, Philadelphia, PA; International School for Advanced Studies (SISSA), Neuroscience Area, Trieste, Italy.
²³ Smell and Taste Clinic, James Paget University Hospital, Gorleston, United Kingdom; Norwich Medical School, University of East Anglia, Norwich, United Kingdom.
²⁴ Department of Otolaryngology-Head & Neck Surgery, Hospital for Sick Children, University of Toronto, Canada.
²⁵ Functional Foods Forum, University of Turku, Turku, Finland.
²⁶ Smell and Taste Research Lab, Institute of Psychology, University of Wroclaw, Poland; Department of Psychotherapy and Psychosomatic Medicine, TU Dresden, Dresden, Germany.
²⁷ Smell and Taste Research Lab, Institute of Psychology, University of Wroclaw, Poland.
²⁸ Smell and Taste Clinic, Department of Otorhinolaryngology, Medizinische Fakultät Carl Gustav Carus, Technische Universität, Dresden, Germany.
²⁹ Frey and Lau, Henstedt-Ulzburg, Germany.
³⁰ Department of Otorhinolaryngology and Head and Neck Surgery, Pardubice Hospital, Faculty of Health Studies, University of Pardubice, Czech Republic.

PMID: 29730147
DOI: 10.1016/j.jpeds.2018.03.011

Multicenter Study

Development of an International Odor Identification Test for Children: The Universal Sniff Test

Valentin A Schriever et al. J Pediatr. 2018 Jul.

. 2018 Jul:198:265-272.e3.

doi: 10.1016/j.jpeds.2018.03.011. Epub 2018 May 2.

Authors

Affiliations

¹ Smell and Taste Clinic, Department of Otorhinolaryngology, Medizinische Fakultät Carl Gustav Carus, Technische Universität, Dresden, Germany; Abteilung Neuropädiatrie, Medizinische Fakultät Carl Gustav Carus, Technische Universität, Dresden, Germany. Electronic address: valentin.schriever@uniklinikum-dresden.de.
² Escuela de Ingeniería, Pontificia Universidad Católica de Chile, Santiago, Chile.
³ Istanbul Smell and Taste Center, Istanbul, Turkey.
⁴ Pediatric Feeding Disorders clinic, Dana Children's Hospital, Tel Aviv Medical Center, Tel Aviv, Israel.
⁵ Pediatric Otolaryngology Unit, Department of Otorhinolaryngology, Head and Neck Surgery, University Hospitals of Geneva, Geneva, Switzerland.
⁶ Escuela de Psicología, Pontificia Universidad Católica de Chile, Santiago, Chile.
⁷ Unidad de Rinología y Cirugía de Base de Cráneo. Servicio de Otorrinolaringología. Hospital Universitario Ramón y Cajal. Madrid, Spain.
⁸ Pediatric Otolaryngology, Dana Children's Hospital, Tel-Aviv Medical Center, Sackler School of Medicine, Tel-Aviv, Israel.
⁹ Departamento de Biología Celular y Fisiología, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Mexico.
¹⁰ Department of Otorhinolaryngology, University College of Medical Sciences and GTB Hospital, Delhi, India.
¹¹ Department of Otorhinolaryngology, Head and Neck Surgery, Cairo University, Cairo, Egypt.
¹² Food Chemistry and Food Development, Department of Biochemistry, University of Turku, Turku, Finland; Department of Food and Environmental Sciences, University of Helsinki, Helsinki, Finland.
¹³ Otorhinolaryngology Department, Aristotle University, Thessaloniki, Greece.
¹⁴ Rhinology-Olfactology Unit, Department of Otorhinolaryngology Head and Neck Surgery, University Hospital of Geneva, Switzerland.
¹⁵ Gösta Ekman Laboratory, Department of Psychology, Stockholm University, Stockholm, Sweden.
¹⁶ Monell Chemical Senses Center, Philadelphia, PA; Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
¹⁷ ORL Clinica, Università of Insubriae Varese, ASST Settelaghi, Varese, Italy.
¹⁸ Unidad de Rinología y Cirugía de Base de Cráneo. Servicio de Otorrinolaringología. Hospital Universitario Ramón y Cajal. Madrid, Spain; INGENIO, Immunoal.lèrgia Respiratòria Clínica i Experimental (IRCE), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, CIBERES, Barcelona, Catalonia, Spain.
¹⁹ Department of Anthropology, Faculty of Humanities, Charles University, Czech Republic; National Institute of Mental Health, Klecany, Czech Republic.
²⁰ Department of Otorhinolaryngology, The Jikei University School of Medicine, Tokyo, Japan.
²¹ INGENIO, Immunoal.lèrgia Respiratòria Clínica i Experimental (IRCE), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, CIBERES, Barcelona, Catalonia, Spain.
²² Monell Chemical Senses Center, Philadelphia, PA; International School for Advanced Studies (SISSA), Neuroscience Area, Trieste, Italy.
²³ Smell and Taste Clinic, James Paget University Hospital, Gorleston, United Kingdom; Norwich Medical School, University of East Anglia, Norwich, United Kingdom.
²⁴ Department of Otolaryngology-Head & Neck Surgery, Hospital for Sick Children, University of Toronto, Canada.
²⁵ Functional Foods Forum, University of Turku, Turku, Finland.
²⁶ Smell and Taste Research Lab, Institute of Psychology, University of Wroclaw, Poland; Department of Psychotherapy and Psychosomatic Medicine, TU Dresden, Dresden, Germany.
²⁷ Smell and Taste Research Lab, Institute of Psychology, University of Wroclaw, Poland.
²⁸ Smell and Taste Clinic, Department of Otorhinolaryngology, Medizinische Fakultät Carl Gustav Carus, Technische Universität, Dresden, Germany.
²⁹ Frey and Lau, Henstedt-Ulzburg, Germany.
³⁰ Department of Otorhinolaryngology and Head and Neck Surgery, Pardubice Hospital, Faculty of Health Studies, University of Pardubice, Czech Republic.

PMID: 29730147
DOI: 10.1016/j.jpeds.2018.03.011

Abstract

Objective: To assess olfactory function in children and to create and validate an odor identification test to diagnose olfactory dysfunction in children, which we called the Universal Sniff (U-Sniff) test.

Study design: This is a multicenter study involving 19 countries. The U-Sniff test was developed in 3 phases including 1760 children age 5-7 years. Phase 1: identification of potentially recognizable odors; phase 2: selection of odorants for the odor identification test; and phase 3: evaluation of the test and acquisition of normative data. Test-retest reliability was evaluated in a subgroup of children (n = 27), and the test was validated using children with congenital anosmia (n = 14).

Results: Twelve odors were familiar to children and, therefore, included in the U-Sniff test. Children scored a mean ± SD of 9.88 ± 1.80 points out of 12. Normative data was obtained and reported for each country. The U-Sniff test demonstrated a high test-retest reliability (r₂₇ = 0.83, P < .001) and enabled discrimination between normosmia and children with congenital anosmia with a sensitivity of 100% and specificity of 86%.

Conclusions: The U-Sniff is a valid and reliable method of testing olfaction in children and can be used internationally.

Keywords: Sniffin' Sticks; children; olfaction; olfactory dysfunction; smell testing.

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Development of an International Odor Identification Test for Children: The Universal Sniff Test

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Development of an International Odor Identification Test for Children: The Universal Sniff Test

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