VIDEO: Technological advancements in atopic dermatitis

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As you might imagine, there's quite a bit out there and probably the first one that's still very useful, I referenced the National Eczema Association earlier and they've had for the last few years an app called EczemaWise, which parents can, or I always say parents, I'm just, I'm a pediatric dermatologist. Perhaps I should have disclosed early on. So I only see children, but parents and patients can download this app and import their own real life data. How many hours of sleep did I lose? How much medicine did I use? How many skin infections did I get? On and on and on, which then can be shared with their provider at an appointment or through their EMR electronic medical record interface. However, to sort of enhance shared decision making and give the provider a much more detailed on-the-ground look at how impactful and how effective treatments perhaps have been for the patient in question. So that's a really useful and important advance.

There are other AI developments that improve the same sort of thing, active disease information from a patient. There are wearable devices that can sort of track itching and sleep loss at night. There are all sorts of things of that nature, which are just painting an entirely different picture for us as providers and allowing patients themselves to track their own symptoms and disease better hopefully for mutual gain. It does things like the EczemaWise app I've mentioned.

I think the other thing, just to extend a point about AI, is true in many disease states. I certainly won't claim that atopic dermatitis is exclusive in this area, but it is pretty remarkable how much misinformation and confusing information there is online for a parent, and not just online, but different providers have different thoughts and very opinion-based recommendations that aren't always grounded in the best evidence. And so it leads parents, again, trying to do the best for their child to go online or see one provider and another provider with something as simple as should they bathe their child? And if so, how often and for how long? If their child has atopic dermatitis and they may go to one source and hear, oh my gosh, bathing dries out the skin. You should only bathe them as little as possible, like once a week and then go to a different provider the very next day who says, "Oh gosh, bathe them every day, that's crazy." And that's really hard.

And so what AI, there's a risk risk there and there's a potential gain there, right? So when we talk about big data and we talk about doing research with big data or meta-analysis or systematic reviews, we use the term garbage in, garbage out, right? Because if you are culling bad data, you end up culling bad data and giving a bad recommendation based on that data. And AI is sort of a prisoner to its own abilities and its own data that it calls. And so there's the risk, the benefit is it can allow a very quick distillation of a lot of disparate information that then at least allows the parent and or the consumer that first step level of analysis that they can then use to have more informed questions at the very least when they do see their provider.

I'm gonna sound like a broken record with the EczemaWise app, but I think that's just in terms of for clinical trials, for instance I do a fair bit of clinical research and our clinical trials require these sort of, these handheld things that the parents insert or input data about how much medicine do they use, how much sleep do they, we've had that for years in the realm of clinical trials, but not necessarily for patients who are not in clinical trials. So I would hope that that sort of rigor and ability for parents and patients to capture their disease state, their concerns, their questions, their triggers, and being able to go over, eczema's notorious for flaring seemingly without cause, and in fact, the original diagnostic criteria for atopic dermatitis, they're called the Hanifin and Rajka criteria. The fourth bullet point is waxes and wanes. So if waxing and waning is built into the definition of the disease, that makes it really hard for, we'll use again a parent and a baby as an example, when they're having different foods they're introducing, different clothes they're wearing, they go to daycare, different experiences. And so the disease wax and wanes, there are a million different variables that makes it really, really hard for parents and providers to sort of sort the wheat from the chaff. And so I think using technology to better capture those exposures and better document for posterity and review and clinical visits is one way I would like to see that go.