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To address the limited evidence from smaller studies, we conducted a meta\u2010analysis on the diagnostic accuracy of olfactory testing in differentiating\n                      <jats:styled-content style=\"fixed-case\">PD<\/jats:styled-content>\n                      from clinical look\u2010alikes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A systematic search was performed in\n                      <jats:styled-content style=\"fixed-case\">PubMed<\/jats:styled-content>\n                      and Web of Science according to the\n                      <jats:styled-content style=\"fixed-case\">PRISMA<\/jats:styled-content>\n                      guidelines. Studies describing results of validated smell tests in\n                      <jats:styled-content style=\"fixed-case\">PD<\/jats:styled-content>\n                      patients and at least one differential diagnosis were included. The risk of bias and applicability was assessed with the\n                      <jats:styled-content style=\"fixed-case\">QUADAS<\/jats:styled-content>\n                      \u20102 tool. For data synthesis, a hierarchical regression model was employed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 787 publications, 23 studies describing 1957\n                      <jats:styled-content style=\"fixed-case\">PD<\/jats:styled-content>\n                      patients, 462 patients with atypical parkinsonian disorders, 239 patients with essential tremor, and 43 patients with secondary parkinsonism were included. The meta\u2010analysis demonstrated a sensitivity of 79% (95% confidence interval [\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      ]: 72%\u201384%) and a specificity of 81% (95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      : 73%\u201386%) for olfactory dysfunction to differentiate\n                      <jats:styled-content style=\"fixed-case\">PD<\/jats:styled-content>\n                      from all other disorders combined. Additional analyses showed consistent sensitivities across sub\u2010analyses, with lowest specificities for the distinction from progressive supranuclear palsy, 64% (95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      : 55%\u201372%), and highest from essential tremor, 92% (95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      : 84%\u201396%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Our findings indicate that olfactory testing shows moderate to good diagnostic accuracy in differentiating\n                      <jats:styled-content style=\"fixed-case\">PD<\/jats:styled-content>\n                      from its main differential diagnoses. While results of olfactory testing alone are insufficient for a definite distinction of\n                      <jats:styled-content style=\"fixed-case\">PD<\/jats:styled-content>\n                      from non\u2010\n                      <jats:styled-content style=\"fixed-case\">PD<\/jats:styled-content>\n                      parkinsonism, it represents an easy\u2010to\u2010use and inexpensive test that may be used in combination with other diagnostic tools.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ene.70473","type":"journal-article","created":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T12:58:56Z","timestamp":1767099536000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The Utility of Olfactory Testing to Discriminate Parkinson's Disease From Diagnostic Mimics: A Systematic Review and 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