Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
Department of Biomedical Engineering, Seoul National University College of Medicine, Seoul, Korea.
J Korean Med Sci. 2021 Feb 8;36(6):e34. doi: 10.3346/jkms.2021.36.e34.
The patients with coronavirus disease 2019 (COVID-19), a worldwide pandemic infection, frequently complain of olfactory disorders. However, psychophysical olfactory tests performed by an examiner are very difficult in these highly infectious patients. This study aimed to develop and validate a questionnaire for olfactory function that can be readily used to evaluate olfactory loss.
Fourteen smell-related questions were created based on smells familiar to Koreans. Among them, questions with a κ value of 0.6 or higher were finally selected through a test-retest reliability analysis. The correlations between the scores of the olfactory questionnaire and those of olfactory function tests (Butanol Threshold Test [BTT] and Cross Cultural Smell Identification Test [CCSIT]) were analyzed. To evaluate the predictive ability of the questionnaire and elicit cutoff values, receiver operating characteristic (ROC) curves were generated.
Out of the 14 questions in the questionnaire, 11 (κ > 0.6) were selected for the olfactory questionnaire. We analyzed 2,273 subjects, and there was a significant correlation between the total score of the olfactory questionnaire and the BTT (r = 0.643, < 0.001) or CCSIT (r = 0.615, < 0.001) scores. ROC curves for the olfactory questionnaire, BTT, and CCSIT all demonstrated high predictive power to discriminate anosmia and severe hyposmia from normosmia. Regarding mild to moderate hyposmia, however, ROC curve for the olfactory questionnaire alone showed high predictive power of discrimination from normosmia. Based on the results of ROC curves among the subclasses, we suggest the classification of the total score of the questionnaire as 0-4, 5-17, 18-27, 28-41, and 42-44, for anosmia, severe hyposmia, moderate hyposmia, mild hyposmia, and normosmia, respectively.
The total scores of the questionnaires correlated with the BTT and CCSIT scores. The symptom questionnaire for olfactory dysfunction may be useful as an alternative tool for olfactory function testing, when unavailable.
2019 年冠状病毒病（COVID-19）是一种全球性的流行感染，患者经常抱怨嗅觉障碍。然而，在这些高度传染性的患者中，由检查者进行的心理物理学嗅觉测试非常困难。本研究旨在开发和验证一种可用于评估嗅觉丧失的问卷。
根据韩国人熟悉的气味，创建了 14 个与嗅觉相关的问题。通过测试-重测信度分析，最终选择κ值为 0.6 或更高的问题。分析嗅觉问卷的分数与嗅觉功能测试（正丁醇阈值测试[BTT]和跨文化嗅觉识别测试[CCSIT]）之间的相关性。为了评估问卷的预测能力并得出截断值，生成了接收者操作特征（ROC）曲线。
问卷中有 14 个问题，其中 11 个（κ>0.6）被选入嗅觉问卷。我们分析了 2273 名受试者，嗅觉问卷的总分与 BTT（r=0.643，<0.001）或 CCSIT（r=0.615，<0.001）的得分之间存在显著相关性。嗅觉问卷、BTT 和 CCSIT 的 ROC 曲线均表现出对辨别失嗅和严重嗅觉减退与嗅觉正常的高预测能力。然而，对于轻度至中度嗅觉减退，嗅觉问卷的 ROC 曲线单独显示出对与嗅觉正常区分的高预测能力。基于 ROC 曲线在子类中的结果，我们建议将问卷总分分为 0-4、5-17、18-27、28-41 和 42-44，分别代表失嗅、严重嗅觉减退、中度嗅觉减退、轻度嗅觉减退和嗅觉正常。
问卷的总分与 BTT 和 CCSIT 的分数相关。嗅觉障碍症状问卷可能是在无法进行嗅觉功能测试时的一种有用的替代工具。
