The usefulness of a quantitative olfactory test for the detection of COVID-19

BackgroundDuring the COVID-19 pandemic, olfactory dysfunction (anosmia or hyposmia) has been reported by many patients and recognized as a prevalent and early symptom of infection. This finding has been associated with viral-induced olfactory neuron dysfunction rather than the nasal congestion typically found in cold- or flu-like states. In literature, the prevalence of anosmia varies from 15% to 85%, and the studies, in general, were based on the subjective evaluation of patients’ self-reports of loss of smell (yes or no question). In the present study, we quantitatively evaluated olfactory dysfunction and the prevalence of fever in symptomatic patients suspected of having COVID-19 using a scratch-and-sniff olfactory test and infrared temperature testing with RT-PCR as the gold-standard comparator method to diagnose COVID-19 infection.MethodsOutpatients had their forehead temperature checked with an infrared non-contact thermometer (temperature guns). After that, they received two olfactory smell identification test (SIT) cards (u-Smell-it™; CT, USA) that each had 5 scent windows and were asked to scratch with a pencil and sniff each of the 10 small circles containing the microencapsulated fragrances and mark the best option on a response card. Nasopharyngeal swabs were then collected for Reverse Transcriptase-Polymerase Chain Reaction (RT-PCR) to determine if the patients were positive or negative for COVID-19 infection. We considered the number of ‘hits’ (correct answers) ≤ 5 as positive for loss of smell (LOS) in the olfactory test; ≥ 6 hits was considered negative for LOS (i.e. normal olfactory function). All data were analyzed using Excel and Matlab software.ResultsIn the present study, 165 patients were eligible for the olfactory test and nasopharyngeal swab collection RT-PCR. Five patients were excluded because of inconclusive PCR results (n=2) and missing data (n=3). A total of 160 patients completed all the protocols. The RT-PCR positivity rate for COVID-19 was 27.5% (n=44), and PCR+ patients scored significantly worse in the olfactory test (5.5±3.5) compared to RT-PCR-patients (8.2±1.8, p<0.001). 0/44 PCR+ patients presented with a fever (≥37.8°C). In contrast an olfactory SIT had a specificity of 94.8% (95% CI, 89.1 – 98.1), sensitivity of 47.7% (95% CI, 32.7 – 63.3), accuracy of 0.82 (95% CI, 0.75 – 0.87), positive predictive value of 77.8% (95% CI, 59.6 – 88.8), negative predictive value of 82.7% (85% CI, 78.7 – 86.7), and odds ratio of 16.7.ConclusionOur results suggest that temperature checking failed to detect COVID-19 infection, while an olfactory test may be useful to help identify COVID-19 infection in symptomatic patients.

Using Response Cards to Increase Student Participation in an Inclusive Classroom

One of the most challenging aspects facing educators today is ensuring academic success for all students in the classroom. Many teachers feel that increasing participation levels of students during instructional time afford students the best chance of academic success. This study analyzed the use of response cards in an eighth grade inclusion math classroom to increase student participation and academic achievement. An AB design study was used to collect data on five students who represented the classroom population of students with and without disabilities. Lesson materials were delivered under two conditions, hand-raising and write-on dry erase board response cards. Results indicated a significant increase in student participation and on-task behaviors during the response card phase. Scores on weekly quizzes and end of unit tests increased after review lessons were conducted with response cards. Recommendations for future studies are included.

Benefits of Electronic Audience Response Systems on Student Participation, Learning, and Emotion

We compared an electronic audience response system (clickers) to standard lecture, hand-raising, and response card methods of student feedback in simulated introductory psychology classes. After hearing the same 30-min psychology lecture, participants in the clicker group had the highest classroom participation, followed by the response card group, both of which were significantly higher than the hand-raising group. Participants in the clicker group also reported greater positive emotion during the lecture and were more likely to respond honestly to in-class review questions.