Date: Thursday, December 25, 2025
I’m Dr. Smith Heavner, a nurse, evaluator, and informaticist, and I serve as Senior Scientific Director of the Data Collaboration Center at the Critical Path Institute, a public-private partnership with the US Food and Drug Administration. At least, that’s what my LinkedIn profile says. But like most of us, I contain multitudes—I’m also a husband, dog parent, disabled, and queer. Yet the piece that most often requires explanation is “evaluator.”
My primary professional home is in drug development—a world hyper-focused on post-positivist empiricism, where even Bayesian methods can raise eyebrows. I work with data extracted from electronic health records (EHR) to generate Real-World Evidence. I often find myself clarifying that qualitative data refers to interviews, observations, or text—not ordinal or categorical scales. Suggesting that subjective perspectives might contribute to valid interpretations can make colleagues…uneasy. But with conversation, curiosity replaces discomfort.
A closer look reveals every dataset—no matter how quantitative—has subjectivity woven into its creation. Someone decided what to measure, how to define it, and when to collect it. Analyses compound the subjectivity because, as Scriven reminds us, every statistician makes value judgments. My role as an evaluator isn’t to erase or control for subjectivity; it’s to illuminate it. By surfacing the motivations, values, and assumptions behind data, I aim to make interpretation more rigorous, transparent, and humane.
Evaluation is an act of translation. It bridges the technical and the contextual, the measurable and the meaningful. It asks not just “What do the numbers say?” but, as Patton might argue, “Who decides what counts as evidence and for whom?” That’s where my intersecting identities matter most. As a queer, disabled nurse working in biomedical informatics, I can’t help but notice how identities shape data—from how “sex” or “gender” are captured in the EHR to how inclusion and exclusion criteria define who is represented in clinical research. Sometimes this lens sharpens insight, like when exploring sex-linked differences in Parkinson’s disease. Other times, it reminds me how easy it is to get distracted by what’s measurable instead of what’s meaningful.
My nursing background anchors me in the lived experience of patients—the messy, complex realities behind the rows and columns of EHR data. The EHR was not designed as an instrument of inquiry; it was built to support clinical documentation, billing, and regulatory compliance. As a result, the data it contains may reflect the operational and economic logics of healthcare systems —and the identities and biases of healthcare providers—more than the lived experiences of patients.
My evaluation practice pushes me to ask: Whose story does this dataset tell, and whose does it erase? Diagnoses appear when access allows them to be made or when reimbursement requires them. Gender is coded to satisfy administrative systems rather than affirm identity. Disability becomes visible when it is billable. These data are not neutral reflections of reality but negotiated representations constructed by professional, institutional, and technological choices.
As an evaluator, my task is not to accept these data at face value but to interrogate the conditions under which they were produced, the assumptions they encode, and the values they privilege. To paraphrase Mertens, only by making those dynamics explicit can we use EHR data responsibly—recognizing both their utility and their limitations as products of a system that quantifies care more easily than it understands it.
Ultimately, being an evaluator in a world that prizes objectivity isn’t about rejecting rigor; it’s about expanding it. When we recognize that all data are social artifacts shaped by human identities and values, both our science and our humanity grow stronger.
The American Evaluation Association is hosting LGBTQ+ Voices in Evaluation TIG Week with our colleagues in the LGBTQ+ Voices in Evaluation Topical Interest Group. The contributions all this week to AEA365 come from our LGBTQ+ Voices in Evaluation TIG members. Do you have questions, concerns, kudos, or content to extend this AEA365 contribution? Please add them in the comments section for this post on the AEA365 webpage so that we may enrich our community of practice. Would you like to submit an AEA365 Tip? Please send a note of interest to AEA365@eval.org. AEA365 is sponsored by the American Evaluation Association and provides a Tip-a-Day by and for evaluators. The views and opinions expressed on the AEA365 blog are solely those of the original authors and other contributors. These views and opinions do not necessarily represent those of the American Evaluation Association, and/or any/all contributors to this site.