Institute of Sport and Movement Science, University of Stuttgart, Stuttgart, Germany.
Appl Neuropsychol Adult. 2022 Sep-Oct;29(5):1208-1220. doi: 10.1080/23279095.2020.1864374. Epub 2021 Jan 4.
One of the key challenges in assessing cognitive performance is to detect not only apparent impairment but to also pick up on subtle differences. Computerized tests benefit especially from the acquisition of fine-grained outcome measures. However, the equivalency of paper-based and computerized tests cannot be assumed. The Trail-Making-Test is a paper-pencil cognitive assessment tool (ppTMT) that has been used in many research studies to evaluate visuomotor abilities and mental flexibility. A digital version of the extended TMT (including a condition measuring fine motor speed) called the dTMT has been developed. This study aims to test (1) reliability, (2) equivalence, and (3) agreement of the ppTMT and dTMT. A total of 53 healthy individuals aged 19 to 82 years of age (22 men, 31 women; mean age 42.2, SD = 22.8) completed three trials per ppTMT and dTMT condition. Part M involves following a predefined path, Part A links numbers randomly distributed in space, in ascending order, and Part B alternates between linking numbers and letters. dTMT scores were highly reproducible, correlated strongly with paper-pencil administered durations, and discriminated young from older adults. Measures of reliability, sensitivity, and clinical meaning for dTMT scores were favorable compared with ppTMT-based testing. Our findings support the comparability of TMT-indices in computerized assessments. While many digital biomarker efforts are in progress (e.g., neurodegenerative disorders), the dTMT sets itself apart through its high sensitivity, the alternate forms, and the additional component measures. In this light, it could serve as a starting point for an early diagnostic tool.
评估认知表现的一个关键挑战是不仅要检测明显的损伤，还要发现细微的差异。计算机测试特别受益于获取精细的结果测量。然而，纸质和计算机测试的等效性不能被假定。连线测试是一种纸笔认知评估工具（ppTMT），已在许多研究中用于评估运动视觉能力和心理灵活性。一种扩展的 TMT 的数字版本（包括测量精细运动速度的条件）称为 dTMT 已经开发出来。本研究旨在测试（1）可靠性，（2）等效性，以及（3）ppTMT 和 dTMT 的一致性。共有 53 名年龄在 19 至 82 岁的健康个体（22 名男性，31 名女性；平均年龄 42.2，SD=22.8）完成了每个 ppTMT 和 dTMT 条件的三次试验。部分 M 涉及遵循预定的路径，部分 A 将随机分布在空间中的数字按升序连接，部分 B 在连接数字和字母之间交替。dTMT 分数具有高度可重复性，与纸质测试的持续时间高度相关，并且可以区分年轻人和老年人。与基于 ppTMT 的测试相比，dTMT 分数的可靠性、敏感性和临床意义测量结果较好。我们的研究结果支持计算机评估中 TMT 指数的可比性。虽然许多数字生物标志物的工作正在进行中（例如，神经退行性疾病），但 dTMT 通过其高灵敏度、交替形式和额外的组件测量来区分自己。在这方面，它可以作为早期诊断工具的起点。
