Does it Matter How We Pose the Question "How is Your Sense of Smell?"

There is a rather large, and unfortunate, discrepancy in the outcome between self-reported and standardized assessment of olfactory function. Questions for self-evaluation are commonly used that provide no information of with what to compare (comparison target) one's olfactory function. We therefore investigated whether responses differed between an unspecific question and two questions providing comparison targets. Ninety-six healthy community-dwelling individuals (62.5 % women) aged 49-80 years evaluated their odor identification ability, followed by standardized assessment of odor identification ability. Results revealed that response patterns varied significantly depending on comparison target. While 81 % reported normal function when no further comparison target was presented, 69 % reported normal function when referring to age-related olfactory changes in identification ability. In turn, sensitivity of the accuracy of self-reported reduced odor identification ability (with standardized assessment as reference) increased from 11 to 37 %, whereas specificity decreased from 86 to 71 % when providing a comparison target. Accuracy of self-reported olfactory function can be increased by including a comparison target. However, standardized assessment is to be preferred over self-reported assessment, irrespective of how the question is formulated.