Screening performance of abbreviated versions of the UPSIT smell test.



Joseph, Theresita, Auger, Stephen D ORCID: 0000-0002-5911-7049, Peress, Luisa ORCID: 0000-0003-0745-2360, Rack, Daniel, Cuzick, Jack, Giovannoni, Gavin, Lees, Andrew ORCID: 0000-0002-2476-4385, Schrag, Anette E and Noyce, Alastair J ORCID: 0000-0003-3027-5497
(2019) Screening performance of abbreviated versions of the UPSIT smell test. Journal of neurology, 266 (8). pp. 1897-1906.

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Abstract

<h4>Background</h4>Hyposmia can develop with age and in neurodegenerative conditions, including Parkinson's disease (PD). The University of Pennsylvania Smell Identification Test (UPSIT) is a 40-item smell test widely used for assessing hyposmia. However, in a number of situations, such as identifying hyposmic individuals in large populations, shorter tests are preferable.<h4>Methods</h4>We assessed the ability of shorter UPSIT subsets to detect hyposmia in 891 healthy participants from the PREDICT-PD study. Shorter subsets included Versions A and B of the 4-item Pocket Smell Test (PST) and 12-item Brief Smell Identification Test (BSIT). Using a data-driven approach, we evaluated screening performances of 23,231,378 combinations of 1-7 smell items from the full UPSIT to derive "winning" subsets, and validated findings separately in another 191 healthy individuals. We then compared discriminatory UPSIT smells between PREDICT-PD participants and 40 PD patients, and assessed the performance of "winning" subsets containing discriminatory smells in PD patients.<h4>Results</h4>PST Versions A and B achieved sensitivity/specificity of 76.8%/64.9% and 86.6%/45.9%, respectively, while BSIT Versions A and B achieved 83.1%/79.5% and 96.5%/51.8%. From the data-driven analysis, 2 "winning" 7-item subsets surpassed the screening performance of 12-item BSITs (validation sensitivity/specificity of 88.2%/85.4% and 100%/53.5%), while a "winning" 4-item subset had higher sensitivity than PST-A, -B, and even BSIT-A (validation sensitivity 91.2%). Interestingly, several discriminatory smells featured within "winning" subsets, and demonstrated high-screening performances for identifying hyposmic PD patients.<h4>Conclusion</h4>Using abbreviated smell tests could provide a cost-effective means of large-scale hyposmia screening, allowing more targeted UPSIT administration in general and PD-related settings.

Item Type: Article
Additional Information: publicationstatus: published
Uncontrolled Keywords: Humans, Parkinson Disease, Olfaction Disorders, Mass Screening, Cohort Studies, Smell, Neuropsychological Tests, Aged, Aged, 80 and over, Middle Aged, Female, Male, Odorants
Depositing User: Symplectic Admin
Date Deposited: 04 Jun 2019 09:49
Last Modified: 19 Jan 2023 00:41
DOI: 10.1007/s00415-019-09340-x
Open Access URL: http://doi.org/10.1016/j.eclinm.2019.04.005
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3044371