Development and Validation of a Chinese Electronic Trail Making Test for Executive Functions Evaluation: A Pilot Study.

The Trail Making Test is a key cognitive assessment for executive functions, yet a reliable electronic version tailored to Chinese-speaking populations is unavailable. This study develops an electronic TMT (eTMT) adapted for Chinese users, incorporating Chinese Zodiac symbols and characters to replace English letters, and evaluates its test-retest reliability. This pilot study introduces a culturally adapted eTMT for Chinese speakers. With 34 older adults, the eTMT showed strong test-retest reliability (Intraclass correlation coefficient and Cronbach's α were reached near 0.7-0.8, p < 0.000) and correlated (correlation coefficients near 0.5 to 0.7, p < .000) well with the paper version. Unlike original pTMT, which only measure completion time, the eTMT also records response times, movement patterns, and error rates, providing a more comprehensive assessment of executive function. These additional data allow for more in-depth analysis, providing a comprehensive assessment of executive function that can be used by clinicians to inform and adjust individualized treatment plans and interventions. The eTMT digital format offers flexibility, eco-friendliness, and richer data, aligning well with sustainable practices in clinical, digital therapeutics, and community settings.