Development and Validation of a Novel At-home Smell Assessment

Gupta, Shruti; Kallogjeri, Dorina; Farrell, Nyssa Fox; Lee, Jake J.; Smith, Harrison; Khan, Adam Z.; Piccirillo, Jay F.

doi:10.1001/jamaoto.2021.3994

Cited by 15 publications

(19 citation statements)

References 33 publications

(46 reference statements)

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“…Inclusion criteria included (1) age 18 to 65 years, (2) residence in Missouri or Illinois, (3) clinical diagnosis of subjective OD of at least 3 months duration associated with COVID-19 infection, (4) objective OD as determined by a University of Pennsylvania Smell Identification Test (UPSIT) 15 score of between 6 and 33 for men or between 6 and 34 for women, (5) possession of all NASAL-7-associated household items. 16 Exclusion criteria included (1) OD due to other etiologies, (2) current use of azelastine, bromperidol, orophenadrine, oxomemazine, kratom, paraldehyde, or thalidomide, (3) history of addiction to alcohol, cocaine, or opioids, (4) impaired kidney function, myasthenia gravis, or myoclonus, (5) severe peanut allergy, (6) pregnancy or attempting pregnancy during study participation, (7) lack of internet access.…”

Section: Participant Selectionmentioning

confidence: 99%

“…Four categories of olfactory function were defined based on the NA-SAL-7 score: anosmia (score 0-4), severe dysfunction (score 5-7), mild dysfunction (score 8-10), and normosmia (score 11-14). 16 The CGI-S scale is a global rating of self-perceived olfactory function. The scale ranges from 1 to 6, with the following response options: (1) excellent, (2) very good, (3) good, (4) fair, (5) poor, and (6) absent.…”

Section: Baseline Assessments and Outcomesmentioning

confidence: 99%

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Efficacy of Gabapentin For Post–COVID-19 Olfactory Dysfunction

Mahadev,

Hentati,

Miller

et al. 2023

JAMA Otolaryngol Head Neck Surg

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ImportanceThe COVID-19 pandemic affected millions of people and has become a dominant etiology of olfactory dysfunction (OD). No interventions with definitive clinical utility exist. Gabapentin represents a potential therapy for COVID-19–induced OD.ObjectiveTo evaluate the efficacy of oral gabapentin on olfactory function and olfaction-related quality of life in patients with COVID-19–induced OD.Design, Setting, and ParticipantsThis pilot double-blinded, placebo-controlled randomized clinical trial (RCT) was conducted at Washington University School of Medicine in St Louis from January 7, 2022, to February 3, 2023. Adults with at least 3 months of OD after COVID-19 infection were eligible for inclusion. Participants with a history of other causes of OD or contraindications to gabapentin were excluded.InterventionPatients were randomized 1:1 to oral gabapentin or placebo. All patients underwent titration to a maximum tolerable dose, which was maintained during an 8-week fixed-dose (FD) phase then tapered off. Participants were monitored for 4 weeks following cessation of study medication.Main Outcomes and MeasuresOutcomes were assessed following the 8-week FD phase and 4 weeks after taper completion. The primary outcome measure was the response rate determined by subjective improvement in OD on the Clinical Global Impression of Improvement (CGI-I) after the FD phase. Other subjective and objective measures of olfactory function were also assessed as secondary outcome measures.ResultsSixty-eight participants were enrolled (34 randomized to each arm), a total of 44 participants completed the FD period and 20 (45.4%) reported response to treatment with at least slight improvement in olfaction from baseline. Of those randomized, 51 (75%) were women and 56 were White (82%) with a mean (SD) age of 43 (13.5) years. Baseline demographic features including age, sex, and race and ethnicity were not significantly different between the groups. Of the 18 participants in the gabapentin group, 8 (44%) were responders and of the 26 participants in the placebo group, 12 (46%) reported response to treatment (percent difference, 1.7%; 95% CI, −31.6% to 28.2%). Mixed-model analysis of all secondary outcome measures demonstrated no clinically meaningful or statistically significant difference between the gabapentin and placebo groups throughout the trial. There were no serious adverse events.Conclusions and RelevanceIn this randomized clinical trial, gabapentin was not associated with statistically significant or clinically meaningful benefit over placebo and likely is not an efficacious therapy for COVID-19–induced OD.Trial RegistrationClinicalTrials.gov Identifier: NCT05184192

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Section: Participant Selectionmentioning

confidence: 99%

Section: Baseline Assessments and Outcomesmentioning

confidence: 99%

Efficacy of Gabapentin For Post–COVID-19 Olfactory Dysfunction

Mahadev,

Hentati,

Miller

et al. 2023

JAMA Otolaryngol Head Neck Surg

Self Cite

View full text Add to dashboard Cite

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“…Scoring ≤ 7 on the NASAL-7 test discriminated anosmic patients from non-anosmics with a sensitivity of 70% and specificity of 53%, whilst scoring ≤ 2 on the NASAL-3 had a sensitivity and specificity of 57% and 78%, respectively. The study was limited by the fact that the participants performed the SIT at home and the screening results were validated against unsupervised psychophysical test scores [ 64 ].…”

Section: Novel Home Testsmentioning

confidence: 99%

Psychophysical Testing in Chemosensory Disorders

Fahmy

Whitcroft

2022

Curr Otorhinolaryngol Rep

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Purpose of Review To provide an overview of psychophysical testing in olfaction and gustation. Recent Findings Subjective patient report correlates poorly with objective assessment of olfaction and gustation. It is therefore important that clinicians and researchers perform psychophysical testing during chemosensory assessment. There are several validated psychophysical tests of olfaction and gustation, with ongoing developments accelerated by the COVID-19 pandemic. These tests have been culturally and linguistically adapted globally. Screening tests have been developed with careful consideration to distinguish normosmics from those with olfactory dysfunction. Summary Validated chemosensory tools are available for use by the clinician to support screening, diagnosis, or monitoring. There are promising advances in self-assessment and screening that provide avenues for the development of a standardised pathway for identification and formal assessment of patients with smell and taste disorders.

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“…The current mainstream therapy for chronic or permanent olfactory dysfunctions include smell training, oral or topical steroids, and nonsteroidal oral medications [99][100][101][102]. Based on the available evidence, smell training is a recommendation with minimal harm effect and highest benefit in improving olfactory function.…”

Section: Potential Stem Cell Therapy For Persistent Odmentioning

confidence: 99%