Development of a Care Guidance Index Based on What Matters to Patients

John H. Wasson
Laura Soloway
L. Gordon Moore
Paul Labrec
Lynn Ho
Peer-Reviewed Article
January 2018

This resource describes a care guidance index based on what matters to patients.


  • Identifying a high-risk subgroup is a strategy for chronic care management. However, common methods of assessing risk are often inaccurate and unhelpful.
  • In search of a better method, the authors of this study developed and tested a “what matters index” (WMI) for patients with chronic conditions. The WMI contains measures of confidence to manage health problems, level of pain, emotional problems, polypharmacy, and adverse medication effects.
  • This study found that the WMI was a good indicator of quality of life. Each sub-measure of the WMI identifies a potentially remediable need for which an intervention is possible.
  • The WMI also immediately identifies populations more likely or less likely to use costly health care.
  • However, since relatively few patients use costly care, both the WMI and a prototypic risk-designation model had comparably low positive predictive values.
  • The WMI is unlikely to predict costly care for an individual patient, but unlike risk models, the WMI can immediately guide care for every patient.
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