94% of atopic dermatitis flare days never reach a clinician.

Folia users tracked their 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. Want your therapy to stand out from the crowd? You’ll need to measure within the Gap.

The “Between Visit” Gap

Right now, 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.

The Research

Usage patterns and the full burden of AD symptoms and flares

One month of tracking from 34 people with atopic dermatitis, with no usage requirements. Participants logged what they chose, when they chose. Of the flare days recorded, 94% never resulted in clinical care. Tracking clustered on Fridays and Saturdays and in the evenings, outside the hours when care is sought. Those days still involved treatment decisions. None of them entered a chart.

Sleep disturbance during flare

The same cohort described their sleep during flare and outside it, using preset tags and tags they created themselves. Markers of restorative sleep appeared more often outside flare. Markers of disruption, itching among them, appeared more often during it. Forty sleep characteristics surfaced in a month. Four of them did not exist until a participant needed one.

What we do

Our Experience in Atopic Dermatitis

  • 650+ people with atopic dermatitis already tracking on the Folia platform for their own personal use, providing a recruitment foundation for AD programs

  • Flare-definition portability demonstrated across atopic dermatitis, sickle cell disease and paroxysmal nocturnal hemoglobinuria

  • 40,000+ patients across the Folia platform

  • 80+ clinician collaborators across active programs

  • Participation that holds: monthly ePRO completion above 85%, post-study retention above 89%, average patient satisfaction 4.8 out of 5

See more of our published work here.

The questions your data can’t answer

  1. How much of the disease are we not seeing?

  2. How fast does relief come, and what does “relief” really look like?

  3. Why do patients stop treatment?

  4. Are we measuring what really matters to patients in their daily lives?

Folia studies can shape endpoints, quantify unmet needs, and prove efficacy and differentiation by answering questions traditional sources can’t. Request a proposal to get started!