INTRODUCTION Failure to provide effortful performance on cognitive testing is not uncommon for participants in clinical trials and can significantly impact sensitivity to treatment effect. Whether poor effort on cognitive testing might relate to other behaviors of interest is unknown. In the current investigation, we examined whether effort on baseline cognitive testing in a randomized controlled trial to enhance resiliency in US Army Officers predicted subsequent success in Ranger school. METHODS Baseline data on six cognitive tests were obtained from 237 US Army Officers entering a military training program prior to attempting Ranger School. Participation was voluntary and the Army was not informed of test scores. "Poor effort" was defined by chance-level accuracy or extreme outlier scores. Logistic regression examined likelihood of Ranger success according to the number of tests with poor effort. RESULTS Overall, 170 (72%) participants provided good effort on all tests. For these participants, 47% were successful in Ranger, versus 32% with poor effort on one test and 14% with poor effort on two tests. Logistic regression analysis found poor effort on baseline testing predicted reduced likelihood of Ranger success, β =-.486, p = .005. DISCUSSION A substantial number of participants exhibited poor effort on testing, and poor effort was predictive of failure in Ranger school. Findings highlight the importance of assessing effort in clinical trials involving cognitive outcomes and suggest application of cognitive effort testing in trials where other motivated behavior is targeted. REGISTRATION Clinical Trials.gov NCT02908932.

中文翻译：

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自愿研究中认知测试的不力预示着美国陆军游骑兵学校的失败：对临床试验设计的影响。

简介 对于临床试验的参与者来说，未能在认知测试中提供努力的表现并不罕见，并且可能会显着影响对治疗效果的敏感性。认知测试方面的不努力是否可能与其他感兴趣的行为有关尚不清楚。在当前的调查中，我们研究了在随机对照试验中为增强美国陆军军官的弹性而进行的基线认知测试的努力是否预示着游骑兵学校随后的成功。方法 六项认知测试的基线数据取自 237 名在参加游骑兵学校之前参加军事训练计划的美国陆军军官。参与是自愿的，陆军不会被告知测试分数。“努力程度差”是由机会级别的准确性或极端异常值来定义的。逻辑回归根据不努力的测试数量检查了 Ranger 成功的可能性。结果 总体而言，170 名 (72%) 参与者在所有测试中都表现出色。对于这些参与者来说，47% 的人在 Ranger 中取得了成功，而 32% 的人在一项测试中表现不佳，14% 在两项测试中表现不佳。逻辑回归分析发现，基线测试的努力不足会导致 Ranger 成功的可能性降低，β =-.486，p = .005。讨论 大量参与者在测试中表现出不努力，而不努力预示着游骑兵学校的失败。研究结果强调了在涉及认知结果的临床试验中评估努力的重要性，并建议在针对其他动机行为的试验中应用认知努力测试。注册临床试验.gov NCT02908932。