4.2 Strengths and limitations
It is essential to highlight the strengths of this cross-sectional survey. Firstly, many respondents with a range of olfactory disorders participated in this survey shedding light on the impact of olfactory disorders on personal health and safety. Secondly, this survey quantified the occurrence of safety scares/incidents in the preceding 5 years allowing qualitative data to be collected detailing such events. Lastly, data were collected anonymously allowing respondents to give honest accounts of their experiences.
However, there are important limitations with this study. Firstly, the major limitation is selection bias of this study as aforementioned. The gender distribution is heavily skewed towards females, and the aetiology of olfactory dysfunction within our population group is different from less biased retrospective studies . This could be because individuals with limited treatment options, such as idiopathic and congenital olfactory dysfunction, seek help from charities and support groups more compared to individuals with e.g. sino-nasal olfactory dysfunction which has more treatment options. In addition, approximately half of the respondents have lived with olfactory dysfunction for more than 5 years, allowing them more time to set mitigations to reduce hazardous events. This may underestimate the 5-year incidence rate. Secondly, all responses were self-reported, including the aetiology of olfactory dysfunction, number of hazardous events, and the details of how the events manifested. These could introduce bias and inaccuracies due to forgetfulness, misunderstanding of questions, or intentional misrepresentation. Thirdly, this survey may be prone to non-response bias, and the response rate is unknown. There might be a non-response bias, i.e., the views of those who did not respond might systematically differ from those who did. Lastly, a subgroup analysis was not conducted to determine which specific demographic groups might be at a higher risk to hazardous events.