Towards universal chemosensory testing: needs, barriers, and opportunities

Millions of people in the United States experience a reduced or distorted ability to smell or taste. Chemosensory disorders such as anosmia (the inability to smell), parosmia (distorted smell), or dysgeusia (altered taste) have major impacts on health and quality of life including difficulty sensing dangers such as fire or spoilage, a diminished palatability of food and drink that can negatively influence diet and nutrition, feelings of social isolation, and an increased incidence of frailty, anxiety, and depression. Smell or taste dysfunction can also be symptoms of other health issues, including sinonasal disease, cancer, or neurodegenerative disease. Aging adults are disproportionately affected. However, smell and taste function are not regularly assessed as a part of routine healthcare despite their prevalence and impact. This is a lost opportunity, as early detection of a chemosensory disorder would enable patients to obtain needed validation, education and support for their health challenge, could direct both patient and provider to treatment options, and may suggest underlying health issues that should be addressed. To better understand the current barriers to including chemosensory testing as a regular component of health care and to identify opportunities to overcome those barriers, the conference "Towards Universal Chemosensory Testing" was convened on November 5-7, 2023, in Philadelphia, PA. This conference brought together scientists, clinicians, patients, and other experts to discuss these issues and identify collective ways to overcome barriers to testing. This white paper-which is focused primarily on the US healthcare system-is the result of those discussions.