94% of atopic dermatitis flare days never reach a clinician.
Folia tracked people with atopic dermatitis at home, in their own words, on their own schedule. The result is a record of disease activity that clinic visits and claims data structurally cannot see.
The Gap
Atopic dermatitis is measured on visit days. EASI, vIGA-AD and SCORAD describe the skin on the day of the appointment. They are clinician-rated and episodic by design.
Most of the disease happens on other days. In Folia's cohort, the overwhelming majority of flare days were managed at home with no clinical contact. Tracking clustered in the evenings and on weekends, outside the windows when care is sought.
Differentiation now lives in the interval. With more than 100 companies developing in atopic dermatitis, separation on clinician-rated endpoints is narrowing. The unmeasured interval is where the remaining argument is.
What HROs record that instruments don't
Patient-reported outcomes measure patient experience. Home-reported outcomes record it.
In Folia's atopic dermatitis cohort, participants tracked 39 unique symptoms and 60 unique treatments that they defined themselves, averaging 4.8 symptoms and 3.1 treatments each. Across the sleep analysis, 40 distinct sleep characteristics appeared. Four of them were created by participants, because no existing tag described what they were experiencing.
An instrument's item list is fixed before the first participant enrolls. Anything a patient would have reported that is not on the list goes uncaptured, and the absence never surfaces. Home-reported outcomes are structured by the patient, so the gaps become visible.