Computerizing Trail Making Test for long-term cognitive self-assessment

Abstract

Purpose This paper aims to adapt and computerize the Trail Making Test (TMT) to support long-term self-assessment of cognitive abilities. Design/methodology/approach The authors propose a divide-and-combine (DAC) approach for generating different instances of TMT that can be used in repeated assessments with nearly no discernible practice effects. In the DAC approach, partial trails are generated separately in different layers and then combined to form a complete TMT trail. Findings The proposed approach was implemented in a computerized test application called iTMT. A pilot study was conducted to evaluate iTMT. The results show that the instances of TMT generated by the DAC approach had an adequate level of difficulty. iTMT also achieved a stronger construct validity, higher test–retest reliability and significantly reduced practice effects than existing computerized tests. Originality/value The preliminary results suggest that iTMT is suitable for long-term monitoring of cognitive abilities. By supporting self-assessment, iTMT also can help to crowdsource the assessment processes, which need to be administered by healthcare professionals conventionally, to the patients themselves.