The Development of Normative Data for the NHANES 8-ITEM Pocket Smell Test®
Tue-P1-039
Presented by: Richard L Doty
Normative data are currently lacking for interpreting scores from the 8-item Pocket Smell Test® (PST®), a brief “scratch & sniff” olfactory screening test derived from the 40-item University of Pennsylvania Smell Identification Test (UPSIT®). Although the basis for the olfactory testing in the 2013-2014 U.S. National Health and Nutrition Survey (NHANES), the 8-item PST® has not been widely employed outside of this context, despite its commercial availability. This is due, in part, to two factors. First, the NHANES sample included only persons 40 years of age or older, thereby limiting its use in younger subjects. Second, the test lacks applicable normative percentile data to allow for determining normal or abnormal function for an individual relative to his or her gender or age, unlike the published norms for the UPSIT® and other widely used olfactory tests. To establish PST® normative data, we combined 3,485 PST® scores from the NHANES database with equivalent PST® items extracted from an UPSIT® database of 3,900 persons ranging in age from 5 to 99 years. Receiver operating characteristic (ROC) curves were used to determine cut-points for defining clinically useful categories of anosmia, probable microsmia, and normosmia. Additionally, decade-related age- and gender-adjusted percentile data were established across the entire age spectrum, making it possible to use the 8-item PST® to determine not only absolute dysfunction (probable microsmia and anosmia), but dysfunction relative to a person’s age and gender. Overall, women outperformed men and an age-related decline in test scores was evident for both sexes after the age of 40 years. Based on the ROC analyses, PST® scores of 3 or less (AUC=0.81) defined anosmia, whereas a score of 7 or 8 (AUC of 0.71) defined normosmia. Probable microsmia was defined as a score ranging from 3 to 6. This study provides an accurate means for interpreting 8-item PST® scores within nunerous clinical and applied settings.