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A novel test to differentiate anosmic malingerers from actually anosmic patients

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The available olfactory evaluation tests are mainly subjective methods requiring patients' collaboration. If, for any reason, the patients refuse to honestly report what they perceive, the test reliability will be questionable; this condition is potentially observable in malingering patients because of their financial or psychosocial incentives. In an olfactory discrimination test context, this study was aimed to design a test capable of distinguishing malingerer from actually anosmic or severely hyposmic patients.


The pilot experiment of our methodology study determined five substances (coffee, lemon, rosewater, thyme, and garlic) as qualified odors of a 20-item odor discrimination test and set its normal reference value at 15. Through two simulations, 70 normosmic participants emulated actual anosmia and also malingering. The outcome results were used to measure test reliability factors.


During the malingering simulation, only seven participants were capable of keeping their scores at the test chance level with enough randomness in their sequences of answers while the actual anosmia simulation revealed that 39 had scores at the test chance level. Accordingly, the Tehran University Odor Discrimination Test (TUODT) was measured to have 90% sensitivity, 55.71% specificity, 67.02% positive predictive value, and 84.78%negative predictive value.


The TUODT is a relatively efficient method to identify anosmia malingerers.

Keywords: Anosmia; TUODT; hyposmic; malinger; odor discrimination; olfactory; simulation

Document Type: Research Article


Affiliations: Department of Otolaryngology, Tehran University of Medical Sciences, Tehran, Iran

Publication date: November 1, 2012

More about this publication?
  • The American Journal of Rhinology & Allergy, is a peer reviewed, scientific publication committed to expanding knowledge and publishing the best clinical and basic research within the fields of Rhinology & Allergy. Its focus is to publish information which contributes to improved quality of care for patients with nasal and sinus disorders. Its primary readership consists of otolaryngologists, allergists, and plastic surgeons. Published material includes peer-reviewed original research, clinical trials and review articles.

    Articles marked "F" offer free full text for personal noncommercial use only.

    Previously published as American Journal of Rhinology, the journal is indexed in Thomson Reuters Web of Science and Science Citation Index, plus the National Library of Medicine's PubMed service.
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