title: Sensitivity analysis and diagnostic accuracy of the Brief Smell Identification Test in patients with chronic rhinosinusitis.
abstract: BACKGROUND
  The Brief Smell Identification Test (BSIT) is an abbreviated version of the Smell Identification Test (SIT) used to assess olfactory function. Although the BSIT can be efficiently administered in under 5 minutes, the accuracy of the BSIT in relation to the SIT in patients with chronic rhinosinusitis (CRS) is unknown.
  
  
  METHODS
  Patients with CRS were recruited as part of an ongoing multi-institutional observational cohort study. A total of 183 participants provided both BSIT and SIT olfactory function scores during initial enrollment. Linear associations between BSIT and SIT scores were evaluated using Pearson's correlation coefficients (rp ). The sensitivity, specificity, and accuracy of BSIT scores were determined using SIT scores as the "gold standard."
  
  
  RESULTS
  A strong bivariate linear association was found between BSIT and SIT scores (rp = 0.893; p < 0.001) for all participants. A significantly lower proportion of patients were identified as having abnormal olfaction using the BSIT compared to the SIT (47% vs 68%, respectively; p < 0.001). Using the currently defined score of ≤8 as a cut-point for abnormal olfactory function, the BSIT demonstrated a sensitivity of 63% and specificity of 88% with an overall accuracy of 71%. Increasing the cut-point to ≤9 resulted in an increased sensitivity of 86%, a specificity of 76%, and an improved overall accuracy of 83%.
  
  
  CONCLUSIONS
  In patients with CRS, BSIT scores strongly correlate with SIT scores; however, the BSIT underestimates olfactory dysfunction as defined by the suggested cut-point of ≤8. Increasing the cut-point to ≤9 increased the sensitivity and accuracy of the BSIT.
authors.affiliation: Division of Rhinology and Sinus/Skull Base Surgery, Oregon Sinus Center, Department of Otolaryngology-Head and Neck Surgery, Oregon Health and Science University, Portland, OR.
authors.forename: Edward
authors.initials: E
authors.lastname: El Rassi
authors.affiliation: Division of Rhinology and Sinus/Skull Base Surgery, Oregon Sinus Center, Department of Otolaryngology-Head and Neck Surgery, Oregon Health and Science University, Portland, OR.
authors.forename: Jess C
authors.initials: JC
authors.lastname: Mace
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of California, Davis, Sacramento, CA.
authors.forename: Toby O
authors.initials: TO
authors.lastname: Steele
authors.affiliation: Division of Otolaryngology-Head and Neck Surgery, Rhinology-Sinus and Skull Base Surgery Program, Department of Surgery, University of Utah, Salt Lake City, UT.
authors.forename: Jeremiah A
authors.initials: JA
authors.lastname: Alt
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Division of Rhinology & Sinus Surgery, Medical University of South Carolina, Charleston, SC.
authors.forename: Zachary M
authors.initials: ZM
authors.lastname: Soler
authors.affiliation: Department of Public Health and Preventive Medicine, Oregon Health and Science University, Portland, OR.
authors.forename: Rongwei
authors.initials: R
authors.lastname: Fu
authors.affiliation: Division of Rhinology and Sinus/Skull Base Surgery, Oregon Sinus Center, Department of Otolaryngology-Head and Neck Surgery, Oregon Health and Science University, Portland, OR.
authors.forename: Timothy L
authors.initials: TL
authors.lastname: Smith
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000857:Olfaction Disorders / Q000175:diagnosis*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D015203:Reproducibility of Results; D012220:Rhinitis / Q000175:diagnosis*; D012680:Sensitivity and Specificity; D012852:Sinusitis / Q000175:diagnosis*; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: CRS; SIT; Smell Identification Test; chronic rhinosinusitis; sensitivity; sinusitis; smell; specificity