ONLINE patient forums may reveal important differences in how atopic dermatitis treatments are perceived, according to a poster presented at SCALE 2026, Nashville, Tennessee, USA.
Patient Sentiment in Atopic Dermatitis
A poster presented at SCALE 2026 described a novel natural language processing approach designed to quantify patient sentiment in atopic dermatitis using anonymous online forum discussions. The analysis found that JAK inhibitors generated the highest Sentiment Positivity Index scores, while lower-potency topical corticosteroids generated the lowest scores.
Atopic dermatitis affects approximately 10–13% of the U.S. population and can substantially impair quality of life through pruritus, pain, and sleep disruption. Traditional quality-of-life tools, including the Dermatology Life Quality Index, capture patient-reported outcomes but may be limited by structured design and short recall periods. Online forums may offer a broader, unfiltered view of patient experience.
Online Forums Capture Treatment Experience
Investigators extracted 322,460 posts from the Reddit r/eczema community between 2017 and 2022 using Pushshift.io. After deduplication and filtering for single-medication mentions, 28,159 treatment-related posts were analyzed.
Text was preprocessed and evaluated using DistilBERT, fine-tuned on the Stanford Sentiment Treebank. Sentiment was classified as positive or negative using a threshold of ≥0.50. The Sentiment Positivity Index was calculated as the proportion of positive posts for each therapy, with 95% confidence intervals.
Dupilumab was the most frequently discussed therapy, appearing in 36.7% of treatment-related posts, followed by topical tacrolimus at 17.5% and antihistamines at 11.9%. Newer agents, including systemic tofacitinib, were rarely mentioned.
JAK Inhibitors Show Highest Positivity
Patient sentiment atopic dermatitis scores varied widely, ranging from 0.116–0.365, with a mean of 0.221. The highest positivity was observed with JAK inhibitors, including upadacitinib at 0.365, ruxolitinib at 0.324, and baricitinib at 0.290.
Lower-potency topical corticosteroids showed the lowest sentiment, including Class V at 0.116 and Class VI at 0.128. These findings may reflect real-world challenges such as adherence burden, steroid phobia, and concerns around topical steroid withdrawal discussed in patient forums.
The authors concluded that natural language processing-derived patient sentiment may complement traditional quality-of-life metrics by capturing real-world treatment perceptions at scale.
Reference
Rajalingam K et al. Novel Sentiment Positivity Index: Natural Language Processing of Online Patient Forums for Atopic Dermatitis. SCALE Music City, 13-17 May, 2026.
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