Trail Making Test Module Overview

Overview

The Trail Making Test (TMT) module is a digital implementation of a standardized cognitive assessment used to evaluate visual attention, task-switching ability, and executive function. The test consists of two parts: TMT-A (connecting numbers in sequence) and TMT-B (alternating between numbers and letters).

Module Structure

The TMT module follows the project’s layered architecture with clear separation of concerns:

Architectural Layers:

Key Features

  • Dynamic Test Generation: Creates tests with configurable number of circles (default 25 or simplified 15)

  • Practice Mode: Allows users to practice with 9 circles before formal testing

  • Hand Selection: Records which hand was used for test completion (left or right)

  • Comprehensive Metrics: Collects detailed performance data including: * Completion time for TMT-A and TMT-B * Error counts (overall and for each part) * Lift metrics (number of times finger is lifted during test) * Pause metrics (number and duration of pauses) * Pressure and size metrics (when supported by device) * Circle-specific metrics (time between and inside circles)

  • Results Analysis: Sections the test into 5 segments for detailed analysis

  • Offline Support: Stores results locally with synchronization when online

  • Reference Code: Links tests to specific reference codes for clinical use

  • User Profiles: Associates tests with user profiles for longitudinal tracking

Test Flow

  1. Mode Selection: User chooses between practice and formal test modes

  2. Hand Selection: User indicates which hand they will use

  3. TMT-A Test: Connecting numbers in sequence (1-2-3…)

  4. Intermediate Screen: Notification that Part A is complete

  5. TMT-B Test: Alternating between numbers and letters (1-A-2-B…)

  6. Results Screen: Displays completion time, errors, and other metrics

  7. Data Synchronization: Results are saved locally and uploaded when online

UI/UX Design

The TMT interface prioritizes:

  • Distraction-free Environment: Clean interface to maintain test validity

  • Real-time Feedback: Visual indicators for correct and incorrect connections

  • Error Handling: Visual and logical handling of connection errors

  • Adaptability: Responsive design for different screen sizes and orientations

  • Accessibility: Configurable circle sizes and contrast options

Technical Implementation

  • Responsive Circle Generation: Dynamically positions circles based on screen dimensions

  • Connectivity Validation: Ensures proper sequencing and detects errors

  • Touch Event Tracking: Records detailed interaction metrics

  • Path Drawing: Visualizes connection paths during test execution

  • Timer Management: Precise timing of overall and segment completion

  • State Management: Manages test flow states using GetX pattern

  • Data Persistence: Stores results in SQLite with cloud synchronization

  • Results Reporting: Formats data for clinical interpretation

The TMT module provides clinicians with a valid digital alternative to the traditional paper-based test while adding the benefits of precise measurement, standardized administration, and advanced performance analytics.