A Modified Test of Goal-directed Behaviour: a Feasibility Study

April 24, 2026 updated by: Gloucestershire Hospitals NHS Foundation Trust

Feasibility Study for Development of a Modified Bedside Test of Goal-directed Behaviour

Cognitive assessment plays an important part in decision making in acute neurological settings, partly because difficulties with cognitive skills such as attention, memory and executive functioning (which includes planning and problem-solving) have direct implications for patents' levels of independence and safety upon discharge.

A bedside cognitive task that could shed light upon a patient's ability to demonstrate effective goal-directed behaviour (potentially along with other aspects of executive functioning such as cognitive flexibility) would be a useful addition to the existing repertoire of bedside cognitive assessments.

One such test could be 'Link's Cube'. The Link's Cube Test is impractical for bedside use in an acute ward setting, as it comprises 27 small blocks. The feasibility study aims to preserve the information that is provided by Link's Cube Test (i.e. an indication of the patient's ability to engage in goal-directed behaviour) whilst altering the testing material such that only nine, slightly larger blocks are used.

The objectives for the feasibility study are:

  • To identify any practical difficulties in administration of the tests that may not be apparent without trialling them
  • To generate information regarding the timing and sequence of overall administration and in particular the proposed modified Link's Cube test
  • To obtain feedback from neuropsychologists about ease of administration of the proposed new test and to obtain their views regarding potential benefits

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Actual)

30

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • United Kingdom
    • Gloucestershire
      • Cheltenham, Gloucestershire, United Kingdom, GL53 7AN
        • Cheltenham General Hospital
      • Gloucester, Gloucestershire, United Kingdom, GL1 3NN
        • Gloucestershire Royal Hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion criteria for the main (non-neuropsychologist) element include:

  • General population. For convenience at this feasibility study stage this will be largely comprised of colleagues working with GHT, above the age of 18, with no upper age limit.
  • Have given informed consent having followed the procedure in the protocol
  • Have the physical/sensory abilities to undertake the test procedures (e.g. use of both hands, adequate vision)
  • Sufficient English language to be able to follow test instructions

Exclusion criteria for the main (non-neuropsychologist) element include:

  • Under the age of 18
  • Refusal/inability to give informed consent
  • Insufficient English language to be able to follow test instructions
  • Using cognitive testing as part of their clinical work, or ongoing familiarity with cognitive tests.
  • Working directly with the main investigator.
  • Presence of a self-reported cognitive difficulty/neurological condition - not because that in itself would be problematic for test administration or for the information generated, but rather to avoid potential distress to participants were they to find the tests administered challenging.
  • Presence of any physical/sensory/cognitive difficulty that would confound administration of the tasks, e.g. being partially sighted or having use of only one upper limb
  • There are no exclusion criteria based on gender identity, ethnicity or handedness.
  • There are no exclusion criteria relating to medication.

Inclusion criteria for the PPI (neuropsychologist) element include:

  • clinical psychologists in GHT who have or have had a role that involves the administration of cognitive tests
  • Have given informed consent having followed the procedure in the protocol
  • Have the physical/sensory abilities to undertake the test procedures (e.g. use of both hands, adequate vision)
  • Sufficient English language to be able to follow test instructions

Exclusion criteria for the PPI (neuropsychologist) element include:

  • Under the age of 18
  • Refusal/inability to give informed consent
  • Insufficient English language to be able to follow test instructions
  • Presence of a self-reported cognitive difficulty/neurological condition - not because that in itself would be problematic for test administration or for the information generated, but rather to avoid potential distress to participants were they to find the tests administered challenging.
  • Presence of any physical/sensory/cognitive difficulty that would confound administration of the tasks, e.g. being partially sighted or having use of only one upper limb
  • There are no exclusion criteria based on gender identity, ethnicity or handedness.
  • There are no exclusion criteria relating to medication.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Supportive Care
  • Allocation: Non-Randomized
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Other: Neuropsychologists
Clinical psychologists in Gloucestershire Hospitals NHS FT
Other: Five cognitive tasks

The five tests are:

  • Link's Cube: participants are asked to construct a large cube from 27 smaller cubes such that the outer surface is all the same colour
  • Modified Links' Cube: participants are asked to construct a large cube from 9 smaller blocks such that the outer surface is all the same colour, and then amend their response according to 2 further instructions
  • D-KEFS Tower Test - participants are asked to move discs of varying sizes across three pegs to build a target tower in as few moves as possible
  • Weigl test - participants are asked to sort blocks into one group according to shape/colour and then shift mental set by sorting them according to the second characteristic
  • Brixton Spatial Anticipation test - participants are asked to detect rules and rule changes when presented a targets that changes location
Other: Non-neuropsychologists
General population, non-neuropsychologists
Other: Five cognitive tasks

The five tests are:

  • Link's Cube: participants are asked to construct a large cube from 27 smaller cubes such that the outer surface is all the same colour
  • Modified Links' Cube: participants are asked to construct a large cube from 9 smaller blocks such that the outer surface is all the same colour, and then amend their response according to 2 further instructions
  • D-KEFS Tower Test - participants are asked to move discs of varying sizes across three pegs to build a target tower in as few moves as possible
  • Weigl test - participants are asked to sort blocks into one group according to shape/colour and then shift mental set by sorting them according to the second characteristic
  • Brixton Spatial Anticipation test - participants are asked to detect rules and rule changes when presented a targets that changes location

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Procedural obstacles of the modified Link's Cube test.
Time Frame: Day 1
Assessed using the Link's Cube Scoring Matrix (total score between 0-30)
Day 1

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Gloucestershire Hospitals NHS Foundation Trust

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

September 15, 2025

Primary Completion (Actual)

April 1, 2026

Study Completion (Actual)

April 1, 2026

Study Registration Dates

First Submitted

January 29, 2026

First Submitted That Met QC Criteria

March 16, 2026

First Posted (Actual)

March 19, 2026

Study Record Updates

Last Update Posted (Actual)

April 27, 2026

Last Update Submitted That Met QC Criteria

April 24, 2026

Last Verified

April 1, 2026

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 25/001/GHT
  • 358626 (Other Identifier: IRAS)

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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