The International Society of Atopic Dermatitis (ISAD) has announced the winner of its TSW Call for Project: the MEDIATE Initiative, short for Mitigating Eczema Disinformation and Intervening with AI Technology Education. The project aims to build an autonomous digital intervention addressing self-diagnosed Topical Steroid Withdrawal (TSW).
According to the project description, dermatologists are increasingly confronting poor treatment adherence driven by corticophobia, a problem worsened over the past decade by rising public awareness of TSW through social media. Patients experiencing rebound flares of undertreated atopic dermatitis often encounter medically inaccurate and alarmist content online, leading many to self-diagnose with TSW, abruptly stop using topical corticosteroids (TCS), and turn to unproven alternative therapies.
To address this gap between evidence-based dermatology and digital peer communities, MEDIATE proposes an automated digital agent powered by a domain-specific Large Language Model. The 12-month study is a collaboration between the Universidade de Sao Paulo, Insper, Imperial College London and the Royal College of Art, and follows a three-phase observational and simulated design.
The first phase involves data mining and psychological mapping, systematically analyzing online community data to understand misinformation narratives and how patients seek and interpret information about TCS and TSW. The second phase focuses on RAG-constrained development, in which the AI agent is co-designed using a Retrieval-Augmented Generation architecture. To prevent hallucinations and ensure psychological safety, all outputs are strictly grounded in a curated knowledge base of dermatologist-validated guidelines, including those from IEC, ISAD, AAD and EADV.
In the third phase, the agent undergoes simulated sandbox testing, being exclusively evaluated within a secure, isolated environment using the mined data, with no contact with real patients or live social media users.
To ensure safety and efficacy, the project will use a Blind Multidisciplinary Review, in which a panel of board-certified dermatologists and clinical psychologists will grade the agent's simulated outputs for medical accuracy, guideline adherence and psychological safety. The project's stated goal is to deliver a safety-proven framework for AI-driven health education that can help mitigate abrupt TCS cessation while giving clinicians deeper insight into patient anxieties.
The project is led by Dr. Jose Pedro de Almeida Silva, who earned his medical degree from Escola Paulista de Medicina (UNIFESP) and completed his Dermatology residency at the Universidade de Sao Paulo (HCFMUSP), where he currently serves as Chief Resident. He recently completed an observership at Hospital 12 de Octubre in Madrid and has served in academic leadership as a Resident Representative. He previously led an award-winning retrospective cohort study on dermatologic surgery outcomes and has investigated patient treatment adherence, with his current research interests centered on the intersection of clinical dermatology, digital health and health communication.