A tool developed for Chinese olfactory screening: culturally adapted version of “Quick olfactory Sniffin’ Sticks Test (Q-Sticks)”

Abstract

Background The odor identification test is culture-dependent. Objectives This study aimed to develop a culturally adapted version of the 5-item Quick olfactory Sniffin’ Sticks Test (Q-Stick) to adapt to the clinical environment in China. Methods The study included 3 phases: (1) develop a culturally adapted version of Q-Stick by replacing unfamiliar odors in the original Q-Stick test (N = 344); (2) validate the culturally adapted version of Q-Stick against two widely used olfactory tests: the Sniffin’ Sticks olfactory test and the 12-item Cross-Cultural Smell Identification Test (CC-SIT) (N = 286); 3) evaluate the test-retest reliability of the culturally adapted version of Q-Stick (N = 60). Results After modification of the interference items, the correct recognition rate of leather was changed from 54.65% to 90.00%. The adapted version of the Q-Stick score significantly correlated with both the Sniffin’ Sticks score (r = 0.7642, p < .0001) and CC-SIT score (r = 0.7403, p < .0001). Normal olfaction is indicated if the culturally adapted version of the Q-Stick score > 4 (specificity 70.00%, sensitivity 83.33%, Youden index 0.533) and Q-Stick score ≤ 4 indicates olfactory dysfunction. The 3-month test-retest reliability coefficient was as high as 0.96. Conclusions and significance The culturally adapted version of Q-Stick is an effective and stable screening tool to identify patients with olfactory dysfunction in China.