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

Author:

Whitcroft Katherine L.1234ORCID,Alobid Isam567ORCID,Altundag Aytug8ORCID,Andrews Peter9,Carrie Sean10ORCID,Fahmy Miriam4ORCID,Fjældstad Alexander W.1112ORCID,Gane Simon39ORCID,Hopkins Claire13ORCID,Hsieh Julien Wen14ORCID,Huart Caroline1516ORCID,Hummel Thomas2ORCID,Konstantinidis Iordanis17ORCID,Landis Baslie N.14ORCID,Mori Eri18ORCID,Mullol Joaquim6719ORCID,Philpott Carl202122ORCID,Poulios Aristotelis4ORCID,Vodička Jan2324ORCID,Ward Victoria M.4

Affiliation:

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

Abstract

AbstractObjectivesOlfactory 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.DesignAnonymous 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.ParticipantsENT surgeons who assess olfaction.ResultsResponses 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.ConclusionsTo 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.

Publisher

Wiley

Subject

Otorhinolaryngology

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