Danish validation of sniffin' sticks olfactory test for threshold, discrimination, and identification.

Objectives: The applicability of olfactory testing is dependent on cultural adaptation. The aim of this study was to validate the Sniffin' Sticks (Burghart Messtechnik, Wedel, Germany) threshold (T), discrimination (D), and identification (I) olfaction test. This data was subsequently used to investigate external validity of international normative values to separate hyposmia from normosmia. Methods: The study included 388 participants. The first step was a questionnaire study in which 238 adults rated their familiarity with 125 odor descriptors. In the second step, we evaluated the original Sniffin' Sticks (Burghart Messtechnik) in 75 participants. In the third step, we modified our odor descriptors and tested 75 participants with the new version. Results: In the I test, we found that 21 original odor descriptors were unfamiliar and that five odors had I rates <75%. After modification, all odors had a successful I rate >75%. By comparing the T, D, and I scores of previous validation studies, we found a significant variation in the scores between countries. Conclusion: The original Sniffin' Sticks (Burghart Messtechnik) was not applicable in Denmark. The modification resulted in improvement of familiarity and rate of I, making the test valid for use in Denmark. Furthermore, the study found a large variation in T and D scores between different countries, which should be considered when using these scores to separate hyposmia and anosmia from normosmia.