Consensus statement on chemosensory testing calls for better standardization, infrastructure, and education

To better understand the current barriers to including chemosensory testing as a regular part of health care, the conference Towards Universal Chemosensory Testing (TUCT) was convened November 5–7, 2023, in Philadelphia, bringing together scientists, clinicians, patients, and other experts for the first time.

From that meeting, a new white paper, published in Chemical Senses, summarizes recommendations on the need for increased chemosensory testing; barriers to its broad implementation, along with opportunities for addressing them; and priorities for making chemosensory testing a common part of everyday health care.

Conference co-organizing institutions with the host, the Monell Chemical Senses Center, were the Massachusetts General Hospital, The Ohio State University, and the University of Florida.

Given that millions of people in the United States have or currently experience a reduced or distorted ability to smell or taste, universal chemosensory testing is an increasingly timely and important topic. This is especially significant because of major impacts on human health, including issues with sensing dangers from fire or food spoilage, a reduced appeal for food and drink that affects diet and nutrition, feeling socially isolated, and increased reports of frailty, anxiety, and depression.

Dysfunction in smell and taste are also early symptoms of such other health issues as cancer and neurodegenerative disorders, including Parkinson’s and Alzheimer’s disease.

“This is a case of many lost opportunities,” said senior author Valentina Parma, Ph.D., Monell Assistant Member and Senior Director of Multisector Engagements.

“Smell and taste function are not regularly checked as a part of routine primary care visits throughout life, so we are missing a chance to enable patients to get the support they need for their health challenges.”

Mounting such a sea change in the health care system is, simply put, complicated.

The stakeholder team tasked with summarizing the presentations and discussion from the 2023 meeting identified seven broad challenges and opportunities for instituting universal chemosensory testing: incorporating into clinical practice, addressing cost and time issues, developing methods for reimbursement, outlining clear health and economic outcomes, establishing regulatory practices, incorporating into health care provider education, and standardizing data collection and sharing.

“Our first priority, and one that kicked off the 2023 conference, is coordinated action among key groups, including researchers, medical professionals, educators, patients, and industry leaders to develop and carry out a clear, strategic roadmap,” said Parma.

To start, the group identified three critical goals to achieve over the next five years:

• Establish standardized types of data collected and names for smell and taste testing for consistency in research and clinical applications.
• Develop infrastructure for widespread implementation, including relevant diagnostic and procedure billing codes, FDA approvals for validated tests, and insurance reimbursement.
• Embed chemosensory assessment into medical and health sciences curricula while at the same time organize public health campaigns to raise awareness of olfactory and taste disorders as critical health indicators.

“Many in the field are working toward the same goals, but doing so in isolation weakens our collective impact,” said Parma. “The TUCT conference and the initiatives that followed are bringing us onto the same playing field, demonstrating that these goals are widely shared and that we’re stronger when aligned.”