Validation of the Hebrew version of the "Sniffin' Sticks" olfactory test: a cross-sectional study in an Israeli cohort.

Abstract

Purpose: Olfactory dysfunction (OD) significantly impacts quality of life, affecting emotional well-being, nutrition, and social interaction. In Israel, where Hebrew is the dominant language, a culturally and linguistically validated olfactory assessment tool is essential. The "Sniffin' Sticks" test is a widely used psychophysical method that evaluates olfactory performance using threshold, discrimination, and identification (TDI) scores. To date, no validated Hebrew version of the test exists.

Methods: A Hebrew version of the identification component (He-I) of the "Sniffin' Sticks" was developed using a standardized forward-backward translation process. Participants completed the full TDI test battery, the University of Pennsylvania Smell Identification Test (UPSIT), and subjective measures, including a visual analog scale (VAS) for olfactory impairment. Diagnostic performance was evaluated using receiver operating characteristic (ROC) analysis, and internal consistency was assessed using Cronbach's alpha (α).

Results: A total of 121 participants were included: 76 patients with olfactory dysfunction and 45 healthy controls. The He-I score showed strong correlations with both TDI (r = 0.93) and UPSIT (r = 0.86). ROC analysis yielded an area under the curve (AUC) of 0.881, with 93.3% sensitivity and 70.6% specificity at a cut-off score of 10.5. Internal consistency was excellent (α = 0.86). VAS scores demonstrated moderate correlation with objective olfactory scores (r = - 0.62, p < 0.001).

Conclusion: The Hebrew version of the "Sniffin' Sticks" identification test is a valid, reliable, and culturally appropriate tool for evaluating olfactory function in Hebrew-speaking populations in Israel.