Validation of the What Matters Index: a brief, patient-reported index that guides care for chronic conditions and can substitute for computer-generated risk models

Introduction: Current health care delivery relies on complex, computer-generated risk models constructed from insurance claims and medical record data. However, these models produce inaccurate predictions of risk levels for individual patients, do not explicitly guide care, and undermine health management investments in many patients at lesser risk. Therefore, this study prospectively validates a concise patient-reported risk assessment that addresses these inadequacies of computer-generated risk models. Methods: Five measures with well-documented impacts on the use of health services are summed to create a \"What Matters Index.\" These measures are: 1) insufficient confidence to self-manage health problems, 2) pain, 3) bothersome emotions, 4) polypharmacy, and 5) adverse medication effects. We compare the sensitivity and predictive values of this index with two representative risk models in a population of 8619 Medicaid recipients. Results: The patient-reported \"What Matters Index\" a...