International clinical assessment of smell: An international, cross-sectional survey of current practice in the assessment of olfaction

Katherine L Whitcroft^{1

2

3

4}, Isam Alobid^{5

6

7}, Aytug Altundag⁸, Peter Andrews⁹, Sean Carrie¹⁰, Miriam Fahmy⁴, Alexander W Fjaeldstad^{11

12}, Simon Gane^{3

9}, Claire Hopkins¹³, Julien Wen Hsieh¹⁴, Caroline Huart^{15

16}, Thomas Hummel², Iordanis Konstantinidis¹⁷, Baslie N Landis¹⁴, Eri Mori¹⁸, Joaquim Mullol^{6

7

19}, Carl Philpott^{20

21

22}, Aristotelis Poulios⁴, Jan Vodička^{23

24}, Victoria M Ward⁴

Affiliations

¹ UCL Ear Institute, University College London, London, UK.
² Smell and Taste Clinic, Department of Otolaryngology, TU Dresden, Dresden, Germany.
³ Centre for Olfactory Research Applications (CORA), IP, School of Advanced Study, London, UK.
⁴ ENT Department, Pinderfields Hospital, Mid Yorkshire Hospitals NHS Trust, Wakefield, UK.
⁵ Skull Base Unit, ENT Department, Hospital Clinic Barcelona University, Barcelona, Spain.
⁶ CIBER of Respiratory diseases (CIBERES), Health Institute Carlos III, Madrid, Spain.
⁷ Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
⁸ Department of Otolaryngology, Head and Neck Surgery, Biruni University School of Medicine, Istanbul, Turkey.
⁹ Royal National and ENT Hospital (RNENT), London, UK.
¹⁰ Department of Otolaryngology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.
¹¹ Department of Otorhinolaryngology, Flavour Clinic, University Clinic for Flavour, Balance and Sleep, Regional Hospital Gødstrup, Herning, Denmark.
¹² Department of Clinical Medicine, Flavour Institute, Aarhus University, Aarhus, Denmark.
¹³ ENT Department, Guy's and St Thomas' NHS Trust, London, UK.
¹⁴ Rhinology-Olfactory Unit, Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital of Geneva Medical School, Geneva, Switzerland.
¹⁵ ENT Department, Cliniques Universitaires Saint-Luc, Brussels, Belgium.
¹⁶ Institute of Neuroscience, Université Catholique de Louvain, Brussels, Belgium.
¹⁷ 2nd Academic Department, Smell and Taste Clinic, Aristotle University of Thessaloniki, Thessaloniki, Greece.
¹⁸ Department of Otorhinolaryngology, Jikei University School of Medicine, Tokyo, Japan.
¹⁹ Rhinology Unit and Smell Clinic, ENT Department Hospital Clinic, University of Barcelona, Barcelona, Spain.
²⁰ Norwich Medical School, Norwich, UK.
²¹ The Norfolk Smell and Taste Clinic, Norfolk and Waveney ENT Service, James Paget and Norfolk and Norwich University Hospitals, Norfolk, UK.
²² Fifth Sense, London, UK.
²³ Department of Otorhinolaryngology and Head and Neck Surgery, Regional Hospital Pardubice, Pardubice, Czech Republic.
²⁴ Faculty of Health Studies, University of Pardubice, Pardubice, Czech Republic.

PMID: 38153760
DOI: 10.1111/coa.14123

International clinical assessment of smell: An international, cross-sectional survey of current practice in the assessment of olfaction

Katherine L Whitcroft et al. Clin Otolaryngol. 2024 Mar.

. 2024 Mar;49(2):220-234.

doi: 10.1111/coa.14123. Epub 2023 Dec 28.

Authors

Affiliations

¹ UCL Ear Institute, University College London, London, UK.
² Smell and Taste Clinic, Department of Otolaryngology, TU Dresden, Dresden, Germany.
³ Centre for Olfactory Research Applications (CORA), IP, School of Advanced Study, London, UK.
⁴ ENT Department, Pinderfields Hospital, Mid Yorkshire Hospitals NHS Trust, Wakefield, UK.
⁵ Skull Base Unit, ENT Department, Hospital Clinic Barcelona University, Barcelona, Spain.
⁶ CIBER of Respiratory diseases (CIBERES), Health Institute Carlos III, Madrid, Spain.
⁷ Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
⁸ Department of Otolaryngology, Head and Neck Surgery, Biruni University School of Medicine, Istanbul, Turkey.
⁹ Royal National and ENT Hospital (RNENT), London, UK.
¹⁰ Department of Otolaryngology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.
¹¹ Department of Otorhinolaryngology, Flavour Clinic, University Clinic for Flavour, Balance and Sleep, Regional Hospital Gødstrup, Herning, Denmark.
¹² Department of Clinical Medicine, Flavour Institute, Aarhus University, Aarhus, Denmark.
¹³ ENT Department, Guy's and St Thomas' NHS Trust, London, UK.
¹⁴ Rhinology-Olfactory Unit, Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital of Geneva Medical School, Geneva, Switzerland.
¹⁵ ENT Department, Cliniques Universitaires Saint-Luc, Brussels, Belgium.
¹⁶ Institute of Neuroscience, Université Catholique de Louvain, Brussels, Belgium.
¹⁷ 2nd Academic Department, Smell and Taste Clinic, Aristotle University of Thessaloniki, Thessaloniki, Greece.
¹⁸ Department of Otorhinolaryngology, Jikei University School of Medicine, Tokyo, Japan.
¹⁹ Rhinology Unit and Smell Clinic, ENT Department Hospital Clinic, University of Barcelona, Barcelona, Spain.
²⁰ Norwich Medical School, Norwich, UK.
²¹ The Norfolk Smell and Taste Clinic, Norfolk and Waveney ENT Service, James Paget and Norfolk and Norwich University Hospitals, Norfolk, UK.
²² Fifth Sense, London, UK.
²³ Department of Otorhinolaryngology and Head and Neck Surgery, Regional Hospital Pardubice, Pardubice, Czech Republic.
²⁴ Faculty of Health Studies, University of Pardubice, Pardubice, Czech Republic.

PMID: 38153760
DOI: 10.1111/coa.14123

Abstract

Objectives: Olfactory dysfunction (OD) is common and carries significant personal and societal burden. Accurate assessment is necessary for good clinical and research practice but is highly dependent on the assessment technique used. Current practice with regards to UK/international clinical assessment is unknown. We aimed to capture current clinical practice, with reference to contemporaneously available guidelines. We further aimed to compare UK to international practice.

Design: Anonymous online questionnaire with cross-sectional non-probability sampling. Subgroup analysis according to subspeciality training in rhinology ('rhinologists' and 'non-rhinologists') was performed, with geographical comparisons only made according to subgroup.

Participants: ENT surgeons who assess olfaction.

Results: Responses were received from 465 clinicians (217 from UK and 17 countries total). Country-specific response rate varied, with the lowest rate being obtained from Japan (1.4%) and highest from Greece (72.5%). Most UK clinicians do not perform psychophysical smell testing during any of the presented clinical scenarios-though rhinologists did so more often than non-rhinologists. The most frequent barriers to testing related to service provision (e.g., time/funding limitations). Whilst there was variability in practice, in general, international respondents performed psychophysical testing more frequently than those from the UK. Approximately 3/4 of all respondents said they would like to receive training in psychophysical smell testing. Patient reported outcome measures were infrequently used in the UK/internationally. More UK respondents performed diagnostic MRI scanning than international respondents.

Conclusions: To our knowledge, this is the most comprehensive UK-based, and only international survey of clinical practice in the assessment of OD. We present recommendations to improve practice, including increased education and funding for psychophysical smell testing. We hope this will promote accurate and reliable olfactory assessment, as is the accepted standard in other sensory systems.

Keywords: UK; assessment; clinical practice; international; olfactory dysfunction.

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References

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International clinical assessment of smell: An international, cross-sectional survey of current practice in the assessment of olfaction

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International clinical assessment of smell: An international, cross-sectional survey of current practice in the assessment of olfaction

Authors

Affiliations

Abstract

References

REFERENCES

MeSH terms

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Full Text Sources

Medical

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