Correlation and agreement of olfactory perception assessed by the Connecticut Chemosensory Clinical Research Center olfactory test and the Brief-Smell Identification Test

Abstract Introduction: Assessing olfactory perception in olfactory disorders is of utmost importance in therapy management. However, the University of Pennsylvania Smell Identification Test and the Sniffin’ Sticks are the only tests validated in Brazil. Objectives: To evaluate the correlation and agreement between the Chemosensory Clinical Research Center olfactory test and the Brief-Smell Identification Test – University of Pennsylvania Smell Identification Test – in healthy participants and in participants with olfactory disorders based on the results and technical aspects of both tests. Methods: Fifty participants without olfactory complaints and 50 participants with olfactory disorders who underwent the Chemosensory Clinical Research Center olfactory test and the Brief-Smell Identification Test were included. The following tests were used for statistical analysis: Mann-Whitney U test, Spearman’s correlation, intraclass correlation coefficient and Bland-Altman plot. An alpha error (significance level) of 0.05 was considered in the statistical analysis. Results: Both tests were effective in distinguishing the groups without the presence of overlapping values for the measured markers. Additionally, there was a strong correlation between Spearman’s correlation and intraclass correlation coefficient between the tests and for both nostrils. However, the correlations were lower when the groups were individually evaluated. The Bland-Altman plot showed no bias when all participants were simultaneously evaluated. Conclusions: The tests to assess olfactory perception presented a high level of agreement. In our sample, we could infer that the Connecticut Chemosensory Clinical Research Center olfactory test is similar to the Brief-Smell Identification Test and can be used in the routine diagnosis of patients with complaints of olfactory disorders, considering the advantage of its low cost.

摘要：在嗅觉障碍的治疗管理中，嗅觉感知评估至关重要。然而，目前巴西境内仅宾夕法尼亚大学嗅觉识别测试（University of Pennsylvania Smell Identification Test）与嗅棒测试（Sniffin’ Sticks）这两项测试获得了官方验证。
目的：本研究基于两项测试的结果与技术特点，评估化学感官临床研究中心（Chemosensory Clinical Research Center）嗅觉测试与简短嗅觉识别测试（Brief-Smell Identification Test，即宾夕法尼亚大学嗅觉识别测试的精简版本）在健康受试者及嗅觉障碍受试者中的相关性与一致性。
方法：本研究共纳入50名无嗅觉主诉的受试者与50名嗅觉障碍受试者，所有受试者均接受上述两项嗅觉测试。统计分析采用Mann-Whitney U检验、Spearman相关分析、组内相关系数（intraclass correlation coefficient）及Bland-Altman图（Bland-Altman plot），设定显著性水平α=0.05作为统计检验阈值。
结果：两项测试均可有效区分两组受试者，测量指标无重叠值。此外，两项测试在双侧鼻孔的Spearman相关系数与组内相关系数均呈强相关性；但分别针对两组受试者进行亚组分析时，相关性有所下降。Bland-Altman图显示，纳入所有受试者整体分析时无系统偏差。
结论：本研究所用的两项嗅觉感知评估测试具有较高的一致性。在本研究样本中，康涅狄格州化学感官临床研究中心（Connecticut Chemosensory Clinical Research Center）嗅觉测试与简短嗅觉识别测试性能相近，考虑到前者成本低廉的优势，可将其用于嗅觉障碍主诉患者的常规临床诊断。