{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T00:11:29Z","timestamp":1790035889890,"version":"4.0.1"},"reference-count":100,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int Forum Allergy Rhinol"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Olfactory dysfunction (OD) is an increasingly recognized but under\u2010investigated comorbidity of cystic fibrosis (CF). Its prevalence, assessment methods, and response to CF\u2010directed treatment, including highly effective modulator therapy (HEMT) remains incompletely characterized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a PRISMA 2020\u2010compliant systematic review (PROSPERO: CRD420251060317) with a database search from inception to December 2025. Studies were eligible if they included participants with confirmed CF and reported an explicit olfactory outcome. Two reviewers independently screened titles and abstracts; full\u2010text screening and Joanna Briggs Institute critical appraisal were initially completed by one reviewer, with a second\u2010reviewer re\u2010check of a random subset. Narrative synthesis was the primary method. An exploratory random\u2010effects prevalence meta\u2010analysis was pre\u2010specified. Sensitivity analyses and exploratory meta\u2010regression by OD case definition and assessment method, and adult\/pediatric subgroup analysis were performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Twenty\u2010nine publications representing 21 unique study populations were included, and 15 distinct assessment instruments were identified. Exploratory meta\u2010analysis pooled OD prevalence (all assessment methods) was 51.9% (95% CI: 29.1\u201374.3%; PI 0.0%\u2013100%; I\n                      <jats:sup>2<\/jats:sup>\n                      \u00a0=\u00a098.2%). In the psychophysical\u2010only sensitivity analysis, pooled prevalence was 58.6% (95% CI: 41.6\u201374.6%; I\n                      <jats:sup>2<\/jats:sup>\n                      \u00a0=\u00a092.0%), with it being significantly higher (\n                      <jats:italic>p\u00a0&lt;\u00a0<\/jats:italic>\n                      0.0001) in adults 76.4% (95% CI: 66.5\u201385.1%;\n                      <jats:italic>n\u00a0=\u00a0<\/jats:italic>\n                      319) than in children (27.3% (95% CI: 9.8\u201348.7%\n                      <jats:italic>n\u00a0=\u00a0<\/jats:italic>\n                      118).\n                    <\/jats:p>\n                    <jats:p>\n                      The pooled Sniffin' Sticks Test score was 26.5 (95% CI: 22.0\u201331.0; 95% PI: 17.7\u201335.4;\n                      <jats:italic>n\u00a0=\u00a0<\/jats:italic>\n                      127), placing the cohort within the hyposmic range. The pooled total SNOT\u201022 score was 35.8 (95% CI: 27.6\u201344.1; 95% PI: 10.2\u201361.4), reflecting substantial overall sinonasal and HRQoL burden. The pooled Lund\u2013Mackay score was 13.5 (95% CI: 11.1\u201315.9), indicating moderate\u2010to\u2010severe radiological sinonasal disease burden. HEMT consistently improved radiological markers of sinonasal disease, but patient\u2010reported HRQoL improvement was variable and did not reach statistical significance in most studies. No included study demonstrated a statistically significant improvement in psychophysical olfactory performance after HEMT, and olfactory minimum clinically important difference was not reached where reported.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>OD is an important comorbidity of CF affecting an estimated 51.9% of people with CF overall, with higher rates in adults than children. Pooled prevalence varies materially by OD case definition and assessment method. Multidimensional psychophysical testing should be considered the reference functional assessment, complemented by olfaction\u2010specific patient\u2010reported outcome measures. HEMT does not appear to restore psychophysical olfactory function in the available studies, supporting continued objective olfactory screening in the modulator era. Prospective longitudinal studies commencing in childhood are needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/alr.70275","type":"journal-article","created":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T23:52:01Z","timestamp":1790034721000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Olfactory Function in Cystic Fibrosis: Outcome Measures, Olfactory Dysfunction Prevalence and the Impact of Management\u2014A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-5621-8725","authenticated-orcid":false,"given":"Luca","family":"Cox","sequence":"first","affiliation":[{"name":"Faculty of Health University of Sheffield, Sheffield Teaching Hospitals NHS Foundation Trust.  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