The development and clinical use of the Guy’s and St Thomas’ quality of life questionnaire (GAST) for adult cochlear implant patients

To Review the benefit of the GAST questionnaire (Tilston, S. 2003. Assessing the quality of life in adult cochlear implant users. MSc dissertation. London: City University.) to measure hearing related quality of life for adults pre and post-cochlear implantation. To develop a scoring methodology as to what score constitutes a significantly ‘good’ or ‘poor’ change to better target rehabilitation to those most in need. The GAST Questionnaire was developed using a robust cycle of validation and reliability analyses using the Statistical Package for the Social Sciences (Norusis, M. 1993. <i>SPSS for windows: professional statistics. release 6.0</i>. Chicago: SPSS Inc.). The scoring methodology was developed by dividing 83 patient full data sets into quintiles for the delta of quality of life improvement and the 9–12 month post-implantation GAST score. The GAST questionnaire design was deemed robust. The scoring methodology used led to the 20th percentile score highlighting individuals requiring further support and the 80th percentiles for those suitable for partial booking. The GAST questionnaire is a useful way of identifying the patients in need of support as well as to measure patient reported quality of life improvements following cochlear implantation.

本研究旨在评估GAST量表（GAST questionnaire）[Tilston, S. 2003. 成人人工耳蜗植入使用者的生活质量评估. 硕士学位论文. 伦敦：城市大学]在测量成人人工耳蜗植入前后听力相关生活质量中的应用价值。同时开发一套评分判定标准，以明确何种分值对应具有显著“良好”或“较差”的生活质量变化，从而更精准地为最有需求的患者提供定向康复干预。

GAST量表的开发依托严谨的效度与信度分析循环，所用统计工具为社会科学统计软件包（Statistical Package for the Social Sciences，SPSS）[Norusis, M. 1993. 《SPSS Windows版：专业统计分析 6.0发行版》. 芝加哥：SPSS公司]。

该评分方法的开发流程为：将83份完整的患者数据集，依据人工耳蜗植入后9至12个月的GAST评分与生活质量改善幅度的差值划分为五分位数。研究证实GAST量表的设计具备良好的严谨性与可靠性。本次采用的评分方法将20百分位数对应的分值作为需要进一步支持的患者的判定标准，80百分位数对应的分值则作为适合接受部分康复服务的患者的判定标准。

GAST量表既可有效识别需要支持的患者，也可用于测量人工耳蜗植入后患者自述的生活质量改善情况。