qU-Sniff - the development of a short version of the Universal "Sniffin' Sticks" test.

OBJECTIVES: Extensive olfactory testing is sparsely applied in pediatric patients in clinical routine especially because of its time taking nature. Therefore a 5-item odor identification test (quick "U-Sniff", "qU-Sniff") from the 12-item "U-Sniff" test was developed. METHODS: A total of 724 normosmic children between 6 and 17 years of age, divided in four age groups, were included in this retrospective study. Additionally, 17 children with congenital anosmia in the same age range were included. To calculate test-retest reliability 90 participants from the healthy group were tested twice. RESULTS: The five most correctly identified odors from the 12-item "U-Sniff" test were: coffee (98 %), peach (95 %), flower (90 %), fish (88 %) and onion (84 %). Normosmic participants scored 4.71 ± 0.62 points on the "qU-Sniff" test. A significant correlation between results of the 12-item and 5-item test (n = 724; rs = 0.580; p < 0.001) and a significant test-retest reliability (rs = 0.626, p < 0.001) were shown. For "qU-Sniff" validation a ROC analysis to distinguish between anosmic patients and healthy controls was conducted for each age group separately. AUCs were as followed: i) 0.963 ± 0.018, p < 0,001; ii) 0.978 ± 0.013, p < 0.001; iii) 0.992 ± 0.006, p < 0.001; iv) 0.994 ± 0.005, p < 0.001. The cut-off value to determine anosmic and normosmic participants was <4 points. CONCLUSION: With the "qU-Sniff" test, we present a short screening tool for clinical routine with <4 points as cut-off to initiate more detailed olfactory testing.

Odor identification performance in children using the "U-Sniff" test - Administered by an untrained person.

OBJECTIVE: The examination of olfactory function of patients with psychophysical olfactory tests such as the "Sniffin' Stick" test is a central component of any olfactory clinical diagnostics and clinical trials. Because olfactory disorders can also occur in childhood, reliable, valid and time-efficient olfactory tests are important. With the "U-Sniff", a child-friendly odor identification test that has already been sufficiently validated is available The aim of this study was to investigate whether untrained persons (e.g. parents with their children) are able to administer the "U-Sniff" odor identification test with appropriate guidance. METHOD: A total of 80 kindergarten children, aged 6 years, underwent an odor identification test. Half of the children were tested by their parents and the other half by a trained examiner. In addition, the examiner performed a concentration test (Kaseler Konzentrationsaufgaben). The results of the two groups were compared. RESULTS: All children completed the rapid testing protocol. No significant differences between the results of the two testing procedures occurred. On average an odor identification score of 9.68 ± 2.02 points (mean ± SD) was reached in the examiner's group while 9.65 ± 2.38 points were observed in the parents' group. CONCLUSION: It can be concluded that this study presents a new testing procedure using the "U-Sniff" odor identification test for children by untrained persons. Further validation of this test procedure examining olfactory impaired children should follow.

Odor identification performance in children aged 3-6 years.

BACKGROUND: While valid and reliable olfactory tests have been developed for children aged >5 years, olfactory testing has not systematically been evaluated in younger children. The aim of this study was to evaluate the reliability and validity of the "U-Sniff" odor identification test in children aged 3-6 years. METHODS: We included 160 healthy children (age range 3-6 years) and 14 congenitally anosmic children. Participants were investigated in two identical sessions. The "U-Sniff" test was used to evaluate olfactory function. A picture identification test (PIT) and the Kasel-Concentration-Task (KKA) were administered to identify factors influencing odor identification performance. RESULTS: Age significantly influenced odor identification performance, with older children achieving higher scores. PIT and KKA scores correlated positively with odor identification scores. The "U-Sniff" test demonstrated a high test-retest reliability (r160 = 0.75, p < 0.001). It was possible to distinguish between healthy and anosmic children by means of "U-Sniff" scores starting at age 4 years with high sensitivity (79-93%) and specificity (88-95%). CONCLUSIONS: The "U-Sniff" test is feasible for children starting at age 3 years. In children aged ≥4 years, it is a reliable and valid method to distinguish between normal olfactory function and anosmia. IMPACT: Olfactory testing is reliable and valid starting at an age of 4 years. The study adds a systematic evaluation of olfactory testing in young children. Results of this study are especially interesting for clinicians in the diagnosis of olfactory dysfunction.