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Point-of-care smell testing serves as an effective screening tool for various neurodegenerative and respiratory conditionsPoint of Care Smell Testing Helps Identify Clinical Needs

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Key Takeaway
Use brief point-of-care smell tests as screening tools, reserving comprehensive batteries for diagnostic precision.

This narrative review evaluates the clinical utility of point-of-care (POC) smell testing, such as UPSIT and Sniffin' Sticks, across various conditions including neurodegenerative diseases, respiratory infections, COVID-19, and psychiatric disorders. The scope covers diagnostic accuracy, administration methods, user-friendliness, and workflow feasibility in primary care and specialty settings.

The authors synthesize evidence to differentiate between screening and diagnostic tools. They conclude that brief POC tests are best positioned as screening tools due to their ease of use. Conversely, comprehensive batteries remain necessary when high diagnostic precision is required for clinical decision-making.

A primary limitation of this review is its nature as a narrative synthesis, which means it does not provide primary data or clinical trial results. The findings represent a qualitative synthesis of existing literature regarding the utility of specific testing tools rather than a quantitative analysis of new trials.

Clinically, the review suggests a tiered approach for practitioners. Clinicians can use rapid screening to identify patients needing further investigation, followed by targeted comprehensive testing when necessary. This framework helps clinicians select appropriate olfactory tests based on the specific clinical setting and patient population.

How this fits prior evidence

This narrative review addresses a gap in practical clinical application for olfactory assessments in neurodegenerative diseases and other conditions. While previous coverage of NINJ1 targeting highlights potential for multiple sclerosis and other neurological conditions, this review focuses specifically on the utility of point-of-care testing tools to identify patients who may require such advanced interventions.

This review looked at the use of point-of-care (POC) smell testing in various medical settings. These tests are used to check a person's sense of smell in clinics for conditions like COVID-19, respiratory infections, and neurodegenerative diseases. The study focused on how easy these tests are to use and how well they work in daily practice.

Researchers found that short, quick smell tests are best used as screening tools. These can quickly identify patients who might need more attention. However, if a doctor needs precise diagnostic information, a more comprehensive battery of tests is still required. This helps doctors decide which test to use based on the time they have and the specific needs of the patient.

Because this was a narrative review, it summarizes existing information rather than providing new clinical trial data. It suggests a tiered approach where rapid screening happens first, followed by detailed testing if needed. Patients should talk to their doctors about how these tests might fit into their specific care plan.

What this means for you:
Quick smell tests are useful for initial screening, while longer tests provide more detail for diagnosis.

Common questions

What is the difference between screening and diagnostic smell tests?

Brief point-of-care tests are best used as screening tools to quickly identify issues. In contrast, comprehensive batteries of tests are still necessary when a doctor requires high precision for a diagnosis. This distinction helps clinicians choose the right test based on the clinical setting and the specific needs of the patient.

What conditions can smell testing help identify?

Smell testing is being used in various medical settings to screen for several conditions. These include respiratory infections, COVID-19, neurodegenerative diseases, and psychiatric disorders. The tests are evaluated based on their accuracy, how easy they are to use, and how quickly they can be performed.

How is smell testing used in a clinical setting?

Clinicians may use a tiered approach for patients. A rapid screening test can be performed first to see if further investigation is needed. If the initial screen shows a need for more detail, a targeted comprehensive test can then be administered to provide a more precise diagnosis.

Study Details

Study typeSystematic review
EvidenceLevel 1
PublishedJun 2026
View Original Abstract ↓
ImportanceOlfactory dysfunction (OD) is increasingly recognized as a clinically relevant biomarker for a wide range of health conditions, including neurodegenerative diseases, respiratory infections such as COVID-19, psychiatric disorders, and age-related sensory decline. Despite its diagnostic value, olfactory testing remains underutilized in routine clinical care due to challenges related to test accessibility, cultural adaptability, cost and practical implementation.ObservationsThis narrative review provides a clinically focused synthesis of olfactory tests suitable for point-of-care (POC), focusing on their diagnostic accuracy, administration methods, user-friendliness, and applicability across diverse clinical populations. Commonly used tests such as the University of Pennsylvania Smell Identification Test (UPSIT®) and Sniffin' Sticks® are discussed alongside emerging rapid screening tools, pediatric assessments, and culturally adapted tests. Attention is given to distinguishing screening tools from comprehensive diagnostic batteries and to the role of point-of-care (POC) testing in primary care, neurology, and otorhinolaryngology settings. Practical considerations including assessment time, workflow feasibility, and clinical decision pathways are also examined. This review emphasizes the translation of available psychophysical tests into a practical POC framework for real-world clinical use.Conclusions and relevanceAvailable olfactory tests vary substantially in diagnostic accuracy, feasibility, and clinical applicability, highlighting the importance of selecting tests based on clinical indication and practice setting. Brief POC tests are best positioned as screening tools, while comprehensive batteries remain necessary when diagnostic precision is required. The main contribution of this review is a clinically oriented framework that distinguishes screening from diagnostic testing and aligns test selection with adult and pediatric clinical scenarios, workflow constraints, and referral needs. A tiered clinical approach using rapid screening followed by targeted comprehensive testing may represent the most practical, cost and time effective strategy for integrating olfactory assessment into routine care. Broader implementation of clinically feasible olfactory testing may improve early disease detection, support clinical decision making, and enhance patient care across conditions associated with OD.
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