The inevitable weakness of metrics
There are plenty of useful things a metric can reveal. There are even more it can obscure or corrupt. It took me well over a decade of tracking my own life in ever greater detail to fully appreciate this duality, which probably reveals something about both me and the nature of measurement.
Like a lot of people bitten by the self-quantifying bug, I initially started gathering personal data to pursue a nebulous collection of goals and desires. As a sedentary technology journalist, I wanted to feel better physically and emotionally, to get outside more, and—where possible—to bring order to some of the messiness and uncertainty of my daily existence. These all seemed to be things that could be improved with the cool clarity of numbers.
Self-quantifiers often get stereotyped as obsessive self-optimizers (and many of them are), but my reasons for producing and collecting personal data were less about life-maxxing and more about life meaning—at least at first. As most people who know me will attest, I do not have now, nor have I ever possessed, a “productivity mindset.” I’m also not all that interested in life hacks, shortcuts, or new ways to compare myself with other people. Instead, what I wanted out of metrics—what I hoped I could divine from a never-ending stream of numbers about my health, work, and social life—was something more elusive: self-knowledge. This was my first mistake.
The idea that the more we know, the better is so profoundly embedded in our culture that it feels weird to even point it out. Since at least as far back as the Enlightenment, the primary way we’ve all agreed to go about knowing more has been through measurement and quantification. After all, more knowledge—more data—leads to better decisions, which leads to happier, more fulfilled people. Or so we’re told, and with increasing frequency in the era of AI.
When two Wired magazine editors, Gary Wolf and Kevin Kelly, coined the term “quantified self” in 2007 and helped launch the movement we are all now helplessly a part of, they were essentially selling this very idea. “Unless something can be measured, it cannot be improved,” wrote Kelly in an early blog post, doing his best impression of Lord Kelvin. “So we are on a quest to collect as many personal tools that will assist us in quantifiable measurement of ourselves.” Almost 20 years later, that quest is easier than ever thanks to a flood of devices, apps, and websites all designed to help us build our self-knowledge through numbers.
My first tool was a small, plastic clip-on Fitbit I started using in 2011. It did one thing: count the number of steps I took in a day. As a lifelong video game player, I was already well acquainted with the motivational power of simple scoring systems, and I hoped my new gadget would offer the gentle numerical nudge I thought I needed to step away from my Twitter feed and, if not touch grass, at least walk next to some. Walking also seemed to be one of the few times I had what could charitably be called intelligent ideas, which seemed like another promising by-product of doing more of it.
Alas, that was short-lived. I can’t tell you precisely when “getting out into nature more” or “thinking smarter thoughts” stopped mattering to me as goals, but I suspect it took no more than a few weeks. What I can say with certainty is that my initial goal of 6,000 daily steps quickly turned into 10,000, which then jumped to 15,000 and eventually settled at 20,000 for years. Stories about becoming a “steps guy” are clichéd at this point, and they’ve earned that status for a reason.
It didn’t take long for me to trade in pedometers for heart-rate monitors (I also started running), smartwatches, sleep-tracking rings, and an embarrassing number of macronutrient-tabulating apps. Outside the health and fitness realm, my early career as a journalist also happened to coincide with the rise of social media and web analytics tools like Chartbeat, which promised to further quantify difficult-to-measure aspects of my life, like “job success” and “impact,” by tracking things like page views, followers, retweets, likes, and all sorts of other attentional metrics that now carry great weight.
Metrics inevitably redefine your core sense of what’s important, whether you’re aware of the trap or not.
Ultimately, during the 10-plus years I diligently tracked my heart rate, steps, active calories, sleep, story engagement time, stress levels, and other metrics, I gained virtually nothing in terms of greater self-knowledge. (I suppose I did learn that I liked to make numbers go up and down, but who doesn’t?) The swirl of data that followed me everywhere did not lend additional meaning or insight to the way I relate to myself, my work, or the important people in my life. In fact, the more I used numerical proxies, the worse I felt about pretty much everything.
What I did learn were two important lessons about what happens when you try to quantify the minutiae of your life. First and foremost, whatever the amount of data you’re currently collecting about yourself, it will never feel sufficient. There’s always a new metric around the corner, a better way for a tracker to remix its readings and more accurately measure what’s “important”: heart rate variability, daily stress, exercise “readiness,” cardiovascular or “fitness” ages. Measurement begets more measurement. You can count on it.

C. Thi Nguyen
The second lesson was less obvious but no less significant. The more personal or nuanced your goals are when you set off on your self-quantifying journey, the more likely it is you will ultimately replace them with some simplified metric or ranking. Want to become a better journalist? Why not use page views and leaderboards as a proxy for success? Enjoy cooking and want to improve? Foodie metrics dictate that more complicated recipes with longer ingredient lists are the answer. Even when we know that the value of good journalism isn’t reflected in how many people read a given story or that the joys of cooking are as much about improvisation and experimentation as about successfully following some complex recipe, it’s hard to resist the allure of a simple score or stat. Metrics inevitably redefine your core sense of what’s important, whether you’re aware of the trap or not.
Over the years, people have invented various terms to describe this phenomenon. In his recent book The Score: How to Stop Playing Somebody Else’s Game, the philosopher C. Thi Nguyen calls it “value capture.” Value capture happens, he says, when you adopt external sources of measurement and then let them rule you without adapting them to suit your life. “In value capture, you’re essentially outsourcing your values,” Nguyen writes. “You’re letting an external metric or ranking set what’s important for you.” Crucially, you’re also outsourcing the process of figuring out your own sense of meaning. It’s why my walks quickly shifted from feeling meditative to prioritizing miles.
Individuals, institutions, and indeed entire societies can fall prey to value capture. In fact, once you start noticing it, you start seeing it everywhere—in journalism, education, and business, but also in our food, our hobbies, and, yes, the way we measure our health and happiness. Here’s how Nguyen puts it:
Value capture happens when a restaurant stops caring about making good food and starts caring about maximizing its Yelp ratings. It happens when students stop caring about education and start caring about their GPA. It happens when scientists stop caring about finding truth and start caring about getting the biggest grants. It even happens in religion. A pastor recently told me that his church had become completely obsessed with baptism rates. The higher-ups had established an internal leaderboard in which the pastors competed on monthly baptism rates, and it was starting to dominate everybody’s attention. He’d found himself caring less about the long-term spiritual development of his flock and focusing more on trying to deliver popular sermons that would up his baptism rates and move him up that leaderboard.
At its core, The Score is trying to untangle a mystery that Nguyen, a specialist in the philosophy of games at the University of Utah, has been thinking about for a long time: Why is it that numbers and scoring systems in games can be the source of so much joy and fluidity and play, but public measures and institutional metrics (i.e., scores that apply to the real world) seem to drain the life out of everything and thrust us all into a bleak mindset of grinding optimization?
To begin to answer this question, he turns to one of the foundational inquiries into the limits of data and quantification, Theodore M. Porter’s 1995 book Trust in Numbers: The Pursuit of Objectivity in Science and Public Life.
Porter, a historian of science who specializes in the social power of numbers, has spent his career looking at why quantification has become so dominant, not just in political and bureaucratic life but everywhere. One of his key insights about the inherent attractiveness of quantification, which he calls “a technology of distance,” is that it “minimizes the need for intimate knowledge and personal trust.” Put another way, metrics travel extremely well between different contexts and are easy to grasp and aggregate.
Whether it’s a student’s GPA or a country’s GDP, these measures are understood by pretty much everyone. But that understanding comes at a price, Porter reminds us: To arrive at a clear metric, you inevitably need to simplify what you’re attempting to measure, often jettisoning heaps of nuanced, qualitative, or open-ended information so that others can find the resulting number legible.
No one (hopefully) believes that a GPA captures in any meaningful way a student’s entire educational experience or aptitude for learning, but we’ve agreed to use it because more qualitative assessments are onerous to wade through and require expertise to decipher and compare. Ditto for the economic metric of GDP, which politicians and societies are now compelled to drive higher and higher because a group of economists once concluded that this figure correlates with general economic well-being.
This is the essential tension at the heart of all data, argues Nguyen. Any institutional quantification, he says, requires that the evaluation procedure and its product be comprehensible across contexts. That profoundly limits what the metric can actually measure. “In value capture, you’re ultimately taking that decontextualized nugget and internalizing it,” he writes. “You’re guiding your life using an evaluative technology that has been engineered to travel between contexts, by stripping it of nuance.”
Every so often I’ll find myself in friendly debate with a “numbers person”—a statistician, an economist, or a friend who’s still a committed self-quantifier. After patiently listening to my measurement-gone-awry examples—the disastrous attempt to quantify pain as “the fifth vital sign” in the mid-1990s (which exacerbated the opioid epidemic), or any of the countless examples of the McNamara fallacy, where decisions in academia, medicine, and politics are based solely on what’s easily measured—many will insist that I’m misunderstanding or misinterpreting the whole point of measuring. Metrics, they’ll say, are simply a means, and the important questions concern the ends for which they are used. In other words, these unfortunate outcomes amount to user error, not something inherently dangerous or misleading about the nature of measurement.
At some point during these conversations, Goodhart’s Law will invariably come up, usually as an explanation the metrics-minded deploy for why the ends get all mucked up. The principle, which is attributed to the British economist Charles Goodhart, is often expressed as the following: “When a measure becomes a target, it ceases to be a good measure.” I have a profound dislike for Goodhart’s Law, not because I think it’s untrue, but rather for the way it gets interpreted.
As Nguyen notes, Goodhart’s Law says very little about why metrics fail to capture what’s important—or what to do about it. Find better measures, some will conclude. Don’t let metrics become targets, others will insist. These are not helpful takeaways. All measurements, I would argue, are in fact targets, whether you intend them to be or not. Metrics inevitably present one direction or option as better, Nguyen writes in The Score—“longer lifespans, faster student graduation rates, more page views, higher customer satisfaction scores.” What people are talking about when they bring up Goodhart’s Law isn’t human error; it’s actually a fundamental problem with measurement itself.
I want to be clear here: Measurement can and does serve a number of vital functions. It has in a very literal sense made the modern world possible, with all its life-saving, suffering-reducing, and awe-
inspiring scientific breakthroughs. When used with care and diligence, metrics can make our progress (or lack of it) clearer and more transparent. Are we decreasing carbon dioxide emissions or not? They can also introduce accountability into formerly opaque systems, such as by measuring whether a company is complying with state and federal regulations. They can even make us more objective, reduce biases, and galvanize us to act.
But as Nguyen points out throughout The Score, the fundamental weakness of metrics comes when we use them to pursue subtler, more personal goals. What I think many of us miss—what I know I certainly missed—is that there are always trade-offs when you try to distill something important down to a data point. When we turn to metrics to understand ourselves, our social world, and culture as a whole, they will never come close to capturing what matters. Even worse, they’ll often actively obscure it.
Today, I find that numbers have very little to offer when it comes to my daily work, my physical or mental fitness, my relationships, or any other part of my life I consider important. Granted, I’m lucky enough to be in relatively good health at the moment. I don’t have to track my glucose levels or monitor my blood pressure. As a freelance writer, I also have the luxury of not having numbers foisted on me in the form of key performance indicators (KPIs), objectives and key results (OKRs), or any of the endless quantitative evaluations that come baked into pretty much every corporate and gig economy job.
Still, in a very real sense, there is no escaping metrics or, especially, the logic that accompanies them. Knowing has become numeric, and we all live in a world that increasingly sees us as a collection of numbers—as “data subjects.” The first and most urgent challenge, I’d suggest, is finding a way to keep us from seeing ourselves and each other that way.
This won’t be easy. As Porter, Nguyen, and countless other philosophers, anthropologists, and historians have already observed, the language of numbers is largely how we ascribe value today—as well as how we digest and metabolize our relationships to ourselves, to others, and to the world around us. Indeed, many of us have accepted not only that metrics have a natural existence in human affairs but that there are in fact no aspects of human life that cannot be somehow translated into data.
Knowing has become numeric, and we all live in a world that increasingly sees us as a collection of numbers— as “data subjects.”
So how do we push back? Nguyen’s book offers a useful first step. As he notes again and again in The Score, believing that numbers say something real or useful about human needs and desires gives them power. We can, at the very least, start to seriously question that belief, to ask what meaning and pleasure we might be giving up in pursuit of a metric.
Doing so will hopefully lead to another realization: that playing the numbers game is ultimately a losing proposition for humans. If we insist on expressing our worth through attentional metrics and productivity scores, if we continue to turn intelligence and creativity into a series of benchmarks for AI to surpass, we’ve already lost. Of course machines will surpass us in a world built around metrics. That is literally what we create them to do. The answer is not to turn ourselves into machines too.
If there’s one thing that keeps me up at night, it is that we’ve become so accustomed to seeing and understanding the larger world and ourselves through numbers that it has deprived us of the language to express what’s fundamental and valuable about our own humanity. We need this ability now more than ever, especially if we’re going to adequately answer two of the most important questions of our era: What are humans for? And what is AI for?
As part of my own attempts to disentangle myself from a life of numbers—efforts that started shortly before covid—I’ve abandoned most of the tools of measurement I spent a decade collecting. I’ve largely given up on social media. I stopped using apps to track my health and well-being. The watch I currently wear tells me the time and the date and nothing else.
In fact, the only holdover from my days of obsessive self-quantification is a dogmatic devotion to walking—without all the step counting, of course. These days, I walk when I’m feeling disillusioned or overwhelmed; I walk when I can’t figure out how to finish an essay; I also walk because I enjoy spending time outdoors with my dog and catching up on the details of my neighbors’ lives. The benefits of pursuing this daily activity are as clear and obvious to me as anything could be in life. I just can’t express them in a number.
Bryan Gardiner is a writer based in Oakland, California.
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Digital Pathology and the NHS: Overcoming Barriers to a More Connected Future
As demand on National Health Service (NHS) U.K. pathology services continues to rise, the shift toward digital pathology has never been more critical. While the NHS 10 Year Plan identifies it as one of the system’s most transformative enablers, digital pathology adoption remains uneven. Damian Doherty, Editor in Chief of Inside Precision Medicine, sat down with Olga Colgan, PhD, strategic marketing director at Leica Biosystems, and Darren Treanor, MB BCh, PhD, consultant histopathologist at Leeds Teaching Hospitals NHS Trust, to explore the pressures facing today’s pathology departments, the transformative potential of digital workflows, and how collaborative partnerships are helping accelerate progress and unlock the full value of digital diagnostics.
Q: The NHS 10 Year Health Plan identifies digital pathology as one of three fundamental shifts, yet adoption remains limited. What are the key barriers?

Olga Colgan: Many pathology departments today are already stretched thin by managing growing workloads, which can make it difficult to pause and do a thorough workflow examination and consider process improvements. Transitioning to digital pathology requires an investment and openness to change. For decades, pathology has been optimized for glass slide review under a microscope, so moving to digital is not just a technology upgrade, but a cultural shift for laboratory staff and clinicians who value the familiarity and comfort of traditional methods.
Proper capital allocation and investment are critical to unlock the benefits of digital pathology. For example, information technology (IT) infrastructure must be capable of supporting high-resolution imaging, secure storage, and rapid sharing of thousands of slides. Regulatory needs must also be considered, as each lab must validate digital workflows to ensure appropriate compliance.
While these upfront hurdles can seem daunting, they lead to significant long-term gains. Digital workflows enable faster slide sharing, improve access to subspecialists, and ultimately improve turnaround times—delivering real benefits for both laboratory teams and patients eagerly waiting for critical results.
Q: What are the key benefits of digital pathology that make it such a crucial step for modernizing NHS pathology services—particularly in terms of workflow efficiency, diagnostic accuracy, and collaborative decision-making?
Colgan: Digital pathology is the quintessential modernization of a pathology laboratory, driving efficiencies in workflows, accuracy, and collaboration. Centralized digital storage provides instant access to prior cases and supports predictive analytics. Eliminating physical slides from the workflow after scanning reduces breakage risks and concerns, misidentification risks, along with space and storage needs.
Beyond efficiency gains, digital pathology unleashes the power of remote collaboration. The ability to share whole-slide images instantly means pathologists can quickly leverage remote expertise within their network, or obtain second opinions in minutes rather than days, accelerating diagnostic confidence and treatment decisions. It also extends expertise beyond geographic boundaries, removing the “postcode-lottery” and providing a basis for equity in pathology diagnostics. This enables rural or underserved regions to access pathologists without the delays, costs, and concerns of physical slide transport. This connectivity transforms pathology into a truly networked resource, ensuring that expertise is available whenever and wherever it’s needed, even after hours.
Further, although in the early stages of routine usage, artificial intelligence (AI) models can add another layer of support by bringing greater quantification and reproducibility to slide analysis, highlighting subtle patterns or abnormalities that may be difficult to identify by eye. Effectively, AI can act as a second set of eyes to further build diagnostic confidence and augment—rather than replace—pathologist review.
Q: How are companies like Leica Biosystems supporting NHS trusts in overcoming digital pathology adoption challenges?
Colgan: It starts with listening. We understand that every laboratory and every pathology department has unique workflows, bottlenecks, and priorities, so our first step is a conversation and analysis to identify those needs and design a tailored roadmap for transformation. This isn’t just about technology; it’s about creating solutions that make the pathology workloads more sustainable, especially at a time when the profession faces significant workforce shortages.
Leica Biosystems partners with labs to deliver systems that meet their demands today, while anticipating future growth and scalability. A great example is Leeds Teaching Hospital and the National Pathology Imaging Co-operative. Combined, they make up the largest national integrated digital pathology network in Europe for routine diagnostics—a milestone that demonstrates what’s possible when technology and collaboration come together. The Leeds Guide to Digital Pathology, volume one and volume two, is packed with practical tips and pragmatic approaches to support successful digital pathology adoption.
Q: What influenced Leeds Teaching Hospital to adopt digital pathology, and what transformation have you experienced?

Darren Treanor: We’ve been involved with digital pathology since the very early days of the technology, and it has become the essential foundation of our teaching and research work at the University of Leeds. We had taken a cautious approach to clinical adoption until we were convinced that the technology was ready—both in terms of clinical safety and technical readiness—and we could ensure that it worked and was safe.
We decided that the threshold for adoption for clinical use was reached in 2015, when we established that the clinical safety was acceptable and that the scanners and viewing software were fit for purpose and would not slow us down. Working in partnership with Leica Biosystems, we adopted a phased approach to 100% digital scanning, starting with a “meaningful pilot” with our four breast pathology colleagues. This group was the most pro-digital in the department and, being located in a separate building, had experienced frustrating delays in the delivery of glass slides between the main lab and their offices. They actively pursued us to “go digital.” The pilot with them was critical for us in planning the laboratory and clinical workflow reconfigurations needed to go digital and, importantly, developing a verification and validation process that allowed us to transition from glass to digital slides while maintaining safety. This process became the foundation of the U.K. Royal College of Pathologists guidelines for digital pathology, which have been adopted in many other countries as well.
We then looked toward the further summit of “100% digital” and took a phased approach, starting with immunohistochemistry (IHC). As a separate part of the lab, this activity could be separately digitized. With digital review of IHC being a lower-risk activity clinically, it allowed us to introduce the rest of our over 40 pathology consultants to the idea of diagnosis on a digital image. Once that was completed, we moved in one final big step to 100% digital scanning, reaching that milestone on a summer’s day in 2018.
Q: What lessons can other NHS trusts learn from your digital transformation journey, and what should be considered as they examine their current workflows?
Treanor: Because of our academic background and partnership with Leica Biosystems, we were very keen to share our experiences of going digital and how to do it. Too many deployments would talk of the great success in using whole-slide imaging, but gloss over the challenges and effort involved in getting there.
We wrote the Leeds guides to provide really simple general-purpose assistance to other labs that are new to digital pathology and didn’t have the benefit of in-house expertise yet.
Looking back, being early adopters, we had the unique challenge of being one of the first centers to go fully digital and pave the way at a time when scanners, displays, and software were just good enough, and the combined global experience of digital pathology was low. We have run many workshops to share our experiences, and it has been interesting to see how the field has evolved in recent times and how much easier it is now to go digital. There are far fewer “unknowns” when going digital now, and modern scanners and workflows are significantly better. For example, our current setup has a very smooth transition from H&E [hematoxylin and eosin] stainer to scanner, which saves a lot of time in the lab and removes a major obstacle to lab operation that we had to work around in the early years. In our early workshops, a deployment was often a multi-year project with a lot of uncertainty and need for a lot of preparatory work; nowadays, labs are much more digital-ready, the timelines are much shorter, and success rates are much higher!
The post Digital Pathology and the NHS: Overcoming Barriers to a More Connected Future appeared first on Inside Precision Medicine.
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Learning to lead in a hybrid human-AI enterprise
As adoption of AI agents looks set to surge by as much as 300% in the next two years, leadership teams are carefully considering the implications of a hybrid human-AI workforce.
Unlike existing enterprise-level automation that relies on manual input, AI agents are capable of autonomously coordinating complex tasks, interacting with multiple tools and environments across an organization. In early applications that center on customer service, HR, and sales, adoption of agentic AI has led to productivity gains of 30-50%.
Their autonomy positions agents more as collaborators than tools, working side-by-side with human employees in blended teams that look poised to upend traditional workplace dynamics.
More than three-quarters of HR leaders believe that the deployment of AI agents will transform existing workplace norms, driving a complete reappraisal of how roles and responsibilities are distributed, how skills are prioritized, and how workplace culture is shaped.
Though many admit they’re in the early or preparatory phase of this shift, 86% of chief HR officers predict that navigating digital labor shaped by agentic AI will be a central component of their role in the years ahead.
Fluency in the change management aspect of agentic AI adoption will be a crucial differentiator when it comes to unlocking the full potential of the technology going forward, believes Ateet Jayaswal, chief culture and employee experience officer at Wipro, a leading technology services and consulting company. This moment is one that he says, “calls for a mindset shift in how HR leaders would enable their organizations.”

Redeploying roles to enable higher-value work
As AI agents assume ownership of more complex and integral tasks, the distribution of roles and responsibilities within an organization will undergo significant change. It’s estimated that three-quarters of current roles will require redesign, reskilling, or redeployment by 2030 as a result of agentic AI.
For leadership, this shift should be about reskilling employees toward higher-value work in order to optimize the potential of an agent-human hybrid workforce, says Jayaswal.
For example, Wipro is a complex organization of 240,000 employees across 65 countries. It previously had multiple policies, documents, and knowledge fragmented across different systems, which delayed response to employee queries.
But the company has recently integrated a custom agentic AI assistant—an agent co-created in partnership with enterprise agentic AI platform Ema Unlimited—that can swiftly navigate this complex system, assuming responsibility for 50 HR tasks that had previously fallen to human employees. With the help of an AI agent, average response time to queries has lowered from 48 hours to five seconds.
Human employees have more time to focus on work “that requires a creative and imaginative mind and cross-functional collaboration, leveraging diverse ideas and thoughts to problem-solve,” says Jayaswal. The AI agent, meanwhile, handles rote administrative tasks like sorting timesheets or helping employees navigate policies and take actions in the flow of work.
When reallocating employee responsibilities, though, it is imperative that humans remain in the loop, Jayaswal caveats. When agentic AI is incorporated into enterprise technology, it must work with sensitive and personal data and therefore needs even more stringent guardrails and constraints than consumer applications. “When you expose an AI agent to organizational data, when you integrate it into multiple enterprise systems, then pathways around the AI agent become extremely important,” he says. “It’s an evolving space that leadership needs to have front-of-mind.” Governance should include robust data privacy rules and the establishment of governance layers, such as an AI council, he suggests.
At a fundamental level, the adoption of AI agents will force a re-evaluation of human roles, believes Jayaswal. Rather than employees primarily performing repetitive tasks or troubleshooting, a significant proportion of their time will shift to designing, teaching, and optimizing an AI agent that can do this work for them with far greater speed and predictability and without the agent getting bored.
“The nature of your job changes from being the hero who comes in to solve the problem to designing the hero who can solve the problem,” he summarizes. “The individuals who I have seen thrive in this environment are the ones who make this shift.”
An evolving employee skillset
Just as roles and responsibilities will be reconfigured to reflect the input of AI agents, the core skills of human employees will be reprioritized. More than four in five HR leaders say they’re planning to reskill workers to become more competitive in a market shaped by AI agents.
Technical skills will be increasingly important. Leading employers such as Salesforce, Danone, and Walmart are already rolling out dedicated AI and digital skills programs that aim to equip everyone from frontline workers to C-suite executives with a baseline level of AI literacy in response to the pervasiveness of the technology.
But desirable soft skills will also evolve, Jayaswal points out. Employees who assign tasks to an AI agent need to plainly articulate what modular steps may be needed to accomplish a task, what the desired outcome should be, and what parameters or guardrails need to be in place to ensure the agent doesn’t access or share confidential data.
As HR executives adapt to a blended workforce, three skills are emerging as top priorities during recruitment, according to a recent survey: relationship building, like forging constructive partnerships and account management; collaboration; and adaptability.
Maintaining a healthy workplace culture
In freeing up human employees to focus on higher-value tasks, the hope is that AI agents can elevate the employee experience, deepening fulfilment and satisfaction in the workplace.
“At Wipro, our vision is to improve the life of Wiproites,” says Jayaswal. “We are taking away non-value added work by embracing modern ways of collaborating, engaging, and transacting, leaving associates with higher order work content.”
But leadership teams embracing agentic AI will also need to plan for the new pressures and stressors that the technology can place on a workforce.
There is already confusion and knowledge gaps, with 73% of HR leaders reporting their employees don’t yet understand how digital labor will impact their work. Many organizations have opted to define AI agents as teammates or colleagues on org charts, but new research says this could erode trust and a sense of professional identity. It also raises new questions around accountability and ownership.
The role of management in addressing these concerns is critical, says Jayaswal. To maintain healthy dynamics, managers need to become skilled at orchestrating blended systems, splitting their focus between supervising AI agents and motivating human employees as they also build and supervise AI agents.
Upgrading employee well-being programs will be a core part of maintaining a robust workplace culture. “As there are more interactions with AI agents, you are losing some of the human touch that was provided by service delivery partners or leaders, or often even by colleagues and peers,” Jayaswal says. Employee services that encourage social connection and empathetic communication may help teams navigate this.
A breakneck transformation
Agentic AI looks set to scale at breakneck speed across many enterprises, and it will significantly transform how these organizations operate.
Carefully considering and deciding how to adapt to this newly blended workforce is now a top priority for leadership teams. Reviewing and refining organizational strategies is essential for optimizing both technological gains and the employee experience.
This content was produced by Insights, the custom content arm of MIT Technology Review. It was not written by MIT Technology Review’s editorial staff. It was researched, designed, and written by human writers, editors, analysts, and illustrators. This includes the writing of surveys and collection of data for surveys. AI tools that may have been used were limited to secondary production processes that passed thorough human review.
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Reporter’s Notebook: The Day the Scientific Debate Died
When the news broke on May 5 that U.S. Food and Drug Administration (FDA) officials had blocked the publication of two major COVID-19 vaccine safety studies in 2025 after being accepted for publication in medical journals, many researchers saw more than a scientific dispute. They saw it as further evidence that America’s most powerful public health agencies were devolving into ideological warfare, institutional instability, and political distrust.
By the time FDA commissioner Martin Makary, MD, resigned a week later on May 12, 2026, there was a growing conflict among scientists, political appointees, public health officials, and outside activists not only over vaccines and public health policy but also over something even more fundamental: who gets to determine what constitutes legitimate science and whether scientific disagreement itself would still be permitted to occur in public.
A decade in the making
Makary’s departure came amid a broader transformation of the FDA and HHS from relatively stable, technocratic agencies into politicized institutions shaped by pandemic-era conflicts. Under Obama-era leaders Robert Califf, MD, and Margaret Hamburg, MD, the FDA emphasized regulatory continuity and evidence-based policymaking, while the Department of Health and Human Services (HHS) focused largely on healthcare administration and implementing the Affordable Care Act.
That changed during the first Trump administration and accelerated during COVID-19, when disputes over vaccines, masking, emergency authorizations, and therapeutics turned the FDA into a political flashpoint. Leadership turnover has increased, tensions between political appointees and career scientists have deepened, and public trust has fractured along ideological lines.
The Biden administration attempted to restore institutional stability by returning Califf to the FDA and appointing lawyer and politician Xavier Becerra, JD, to HHS, but the agencies remained mired in conflicts over pandemic policy and public health authority. Under HHS Secretary Robert F. Kennedy Jr. in the second Trump administration, those tensions intensified further through staffing and funding cuts, ideological battles over vaccines and food policy, and growing distrust inside federal health agencies.
Makary initially aligned with parts of the administration’s “Make America Healthy Again” (MAHA) agenda, particularly on food reform and criticism of segments of the pharmaceutical industry. But reports suggest he became caught between competing pressures from the White House, HHS leadership, industry groups, conservative activists, and public-health officials. He ultimately resigned amid disputes over vaping regulation, drug approvals, and broader public health policy during a sweeping restructuring of federal health agencies. Reports also indicated he was already at risk of removal and that his departure was not directly tied to controversy over the blocked COVID publication.
Instead, the move signals the White House’s continued support for Robert F. Kennedy Jr., “MAHA,” and a shift toward more centralized control over food-safety strategy, inspections, and outbreak response—changes that could affect how aggressively the FDA enforces nutrition standards and responds to contamination events. More broadly, the episode has done little to ease concerns among scientists and public-health experts that political considerations are increasingly shaping regulatory decisions and narrowing the space for independent scientific debate within federal health agencies.
Seeing double(think)
One of the two was posted online as a medRxiv preprint in 2025 by lead author Joann F. Gruber, PhD, and senior author Steven A. Anderson, PhD, and examined updated Covid-19 vaccines in adults over 65, the population most vulnerable to severe disease and death from the virus. The analysis drew on data from 7.6 million Medicare FFS beneficiaries who received a COVID-19 vaccination in 2023–2024—either the Pfizer-BioNTech (3.68 million) or Moderna (3.84 million) mRNA vaccine or the Novavax protein-based vaccine (30,000)—and found no new vaccine safety signals.
But before the study could move through peer review, publication was halted by the FDA, according to a spokesperson for the HHS. As reported by the New York Times, an HHS spokesperson said the studies were withdrawn “because the authors drew broad conclusions that were not supported by the underlying data. The FDA acted to protect the integrity of its scientific process and ensure that any work associated with the agency meets its high standards.”
Both Gruber, whose work with the FDA’s Center for Biologics Evaluation and Research (CBER) began in 2017, and Anderson, a veteran of CBER having joined in 2001, left the FDA at some point in 2025. It’s worth noting that Anderson’s team posted a second preprint on influenza vaccines that mirrored the COVID-19 vaccines study, using the same patient population, on the same day, which was also posted online as a medRxiv preprint on January 5, 2025, and was accepted in the peer-reviewed journal Vaccine on March 25, 2025, and made available online April 8, 2025.
On June 25, 2025, Makary and former CBER director Vinay Prasad, MD, PhD, in conjunction with manufacturers, added class safety warnings for myocarditis and pericarditis to COVID-19 mRNA vaccines’ prescribing information. The exact timing of when the accepted Gruber and Anderson study was pulled from publication has yet to be reported. That it occurred before June 2025 to prevent contradiction with Makary’s and Prasad’s safety update to the COVID-19 mRNA vaccine is entirely possible. Anderson’s team posted a second preprint on influenza vaccines that mirrored the COVID-19 vaccines study, using the same patient population, on the same day, which was also posted online as a medRxiv preprint on January 5, 2025, and was accepted in the peer-reviewed journal Vaccine on March 25, 2025, and made available online April 8, 2025.
Both Gruber, whose work with the FDA’s Center for Biologics Evaluation and Research (CBER) began in 2017, and Anderson, a veteran of CBER having joined in 2001, no longer work at the FDA. According to their LinkedIn profiles, Gruber left in June 2025 and Anderson in December 2024.
Gold-standard science
I spoke with several leading epidemiologists to assess whether there was substance to the HHS statement. All immediately noted the lack of specificity in the agency’s criticism, particularly the vague references to “gold-standard science.”
An epidemiologist with experience conducting vaccine safety studies, requesting anonymity, told Inside Precision Medicine, “If someone wants to criticize the study, there should either be a very clear articulation of what exactly they mean when they invoke terms like ‘gold-standard science’—specifically, which methods are acceptable, which are not, and why—or they should bring to the table the scientific credibility that would justify dismissing this kind of work outright. Frankly, neither of those things has happened. Broad, nonspecific attacks like these actually undermine the critique itself.”
The epidemiologists I spoke to emphasized that the study’s methods were not novel but reflected established approaches used in vaccine surveillance and prior scientific work, including self-controlled case series and cohort studies. A Harvard University researcher familiar with the study said the framework was specifically designed for this purpose. “The system/infrastructure (FDA BEST), data source, study design, and analytic approach are all fit-for-purpose for the study question,” the Harvard researcher told me. “Self-controlled designs are robust and control for non-time-varying factors, especially in adults.”
Céline Gounder, MD, an infectious disease specialist, epidemiologist, and editor-at-large for public health at KFF Health News, said the report used one of the strongest available methods for post-market vaccine surveillance. “This study used one of the best methods we have to check if vaccines cause side effects, and it found that the updated COVID vaccines are safe,” Gounder told me. “Pulling this study from publication doesn’t protect good science. It’s not radical transparency, and it’s not gold-standard science.”
Gounder also noted that the study analyzed data from more than seven million people and found no new safety concerns. “That’s a careful conclusion backed by solid data,” she said. “Blocking a study because you don’t like the answer is censorship.”
Indeed, the consensus among interviewees was that the study appeared adequately powered and appropriately cautious in its conclusions. “This study includes a large number of people, and from what I can see, it appears adequately powered for the conclusions they’re making,” said the epidemiologist with vaccine expertise. “Importantly, the authors are framing the findings appropriately. They are not claiming more than the data support. Their framing is essentially ‘No new safety signals identified.’ That’s a careful and reasonable way to present findings like this.”
The study also openly acknowledged limitations, including possible outcome misclassification and residual uncertainty, while describing how these issues were addressed in the analysis. “Seasonality can be a concern with the study design, but it was adjusted for in the study,” said the Harvard researcher. “Claims data are well equipped for studying the exposure and outcomes of interest… In this study, misclassification was accounted for.”
Steven Goodman, MD, PhD, associate dean of clinical and translational research and professor of epidemiology and population health and medicine at Stanford University, told Inside Precision Medicine the study was informative and aligned with broader evidence supporting the low-risk profile of COVID vaccines in adults over 65. Goodman also highlighted the restraint of the authors’ interpretations. “They do not make a statement about the risk-benefit balance, which they can’t because they didn’t study the benefit, but they note that the FDA felt that the balance was positive,” he said. “Their main conclusion was, ‘Our study contributes to growing evidence on the safety of COVID-19 vaccines.’ It is hard to argue with that.”
Goodman added, “All studies have strengths and limitations, i.e., none establish a scientific truth all by themselves. But this is fundamentally good science that adds valuable information to the COVID vaccine safety picture in adults >65.”
The epidemiologists stressed that vaccine safety science depends on cumulative evidence across multiple studies, methods, and datasets. “Public health surveillance has always operated this way,” the Harvard University researcher said. “No single study claims to be the final word on a topic. You accumulate evidence across multiple studies, multiple methods, and multiple datasets and then interpret the totality of evidence together.”
The Harvard researcher added, “The results are consistent with what has been reported by others, including in other countries. There is no clear scientific reason for this work being pulled from publication.”
Truth welcomes questions
Further, many of the epidemiologists I interviewed stressed that publication does not imply unquestioned acceptance. Instead, they argued that publication serves as the mechanism through which scientific claims challenge, refine, or overturn one another.
Goodman emphasized that the unpublished manuscript was intended for scientific scrutiny and peer review and said imperfections in such work are neither unusual nor disqualifying. “Is it perfect? No, but this is a preprint, and usually the peer review and editing process improves the analyses, exploring robustness to various assumptions, the reporting, and the interpretation,” he said. “I would presume that the final version would have come out with some more qualifications, limitations, sensitivity analyses and caveats.”
The experts I contacted emphasized how suppressing publication interrupts the ordinary process through which scientific consensus develops. “This study should be out there, clearly labeled as one piece of evidence among many, with all the necessary caveats attached,” said the epidemiologist. “Then additional studies come in, more data accumulate, and eventually the field interprets the evidence in totality.”
The unnamed epidemiologist added, “For 250 years, this country has benefited from exactly that: reasonable people openly disagreeing about difficult issues. So why not say, ‘Fine, publish the study,’ and then publish an editorial alongside it explaining the caveats, limitations, and alternative interpretations? That’s how science is supposed to work. You respond to speech you disagree with by adding more speech, not by suppressing speech and certainly not by suppressing scientific speech.”
Several of the epidemiologists argued that blocking the manuscript conflicts with repeated public calls for open scientific debate from directors at agencies under the purview of HHS, notably Jay Bhattacharya, PhD, Director of the National Institutes of Health (NIH).
Goodman said that how the FDA handled this study “contrasted with Dr. Bhattacharya’s many public remarks stressing the criticality of open discussion of scientific results and his objections to suppressing science whose results one doesn’t like. The forced withdrawal of this manuscript prevented that process from occurring, shutting down the open discussion Dr. Bhattacharya has called for in innumerable forums.”
Goodman added that if officials believe the study contains fatal flaws, they should articulate those concerns publicly and subject them to scientific scrutiny, “letting the authors respond and the scientific community decide… Their own critique should be subjected to peer review.”
The fundamental process of science encourages that disputes over evidence should unfold transparently in scientific journals and public debates. “If someone has objections, they should make those objections publicly and specifically in the scientific literature where others can critique them, evaluate them, or even prove them right,” said the epidemiologist. “That’s how science advances. That’s what real science looks like: gold-, platinum-, titanium-, or whatever rare metal metaphor people want to use for standards. The scientific enterprise in this country has succeeded because ideas are tested openly, criticized openly, and refined openly. This kind of amateur hour behavior at regulatory agencies doesn’t help anybody.”
Nostrums, not normalcy
The culling of FDA scientists, be it via resignations or firings in 2025–2026, has continued since Makary’s resignation. Tracy Beth Hoeg, MD, PhD, the head of the FDA’s Center for Drug Evaluation and Research (CDER), was fired Friday (according to a social media post reported by Reuters on Sunday) and replaced by Michael Davis, MD, PhD, who had served as deputy director of CDER for about a year.
There is no concrete evidence connecting the FDA’s blocking publication of two studies accepted into medical journals to Makary’s departure. But the contradictory messaging within the agency on COVID-19 mRNA vaccines—the product of Operation Warp Speed, considered a signature accomplishment of the first Trump administration—is obvious. The collapse of confidence within institutions that once relied on scientific independence as their organizing principle. Increasingly, senior scientists and regulators appear unwilling to publicly defend decisions, studies, or processes they privately regarded as scientifically sound. That shift matters more than any single resignation.
The appointment of Kyle Diamantas as acting head of the FDA, however, is far from a course correction, marking another sharp turn away from independent scientific leadership at America’s top health regulator. A former corporate lawyer for Abbott Laboratories with no medical or research background, Diamantas rose through the agency by advancing the “MAHA” food agenda and cultivating ties to politically aligned health influencers rather than the scientific establishment. A close friend of Donald Trump Jr., the appointment of the 38-year-old Diamantas only reinforces concerns that ideological loyalty is increasingly outweighing scientific expertise inside the FDA.
For decades, FDA and HHS leadership operated with relative continuity, assuming that disputes would be resolved through open scientific debate. That assumption now appears badly weakened. The blocked vaccine safety study became symbolic not merely because of the substance of the research but also because even many scientists who believed the work was rigorous hesitated to say so publicly. When experts become reluctant to attach their names to conclusions that they consider obvious or well-supported, the problem extends beyond politics or personnel. It reflects a deeper institutional fear inside the scientific establishment itself.
Makary’s resignation earlier this month therefore represented more than another leadership change in Washington. It exposed how federal health agencies have been pulled into a culture where scientific judgments are increasingly filtered through ideological loyalty, political risk, and reputational self-preservation. The larger danger is not only instability at the FDA or HHS, but the emergence of a scientific culture in which silence becomes safer than candor. Institutions built to evaluate evidence cannot function for long under those conditions.
The post Reporter’s Notebook: The Day the Scientific Debate Died appeared first on Inside Precision Medicine.
Microbiome Therapy Could Help Drug-Resistant Melanoma Patients
Microbiotica, a microbiome-focused biotech based in Cambridge in the U.K., has achieved good Phase Ib results in a trial of its microbiome therapy for patients with advanced melanoma skin cancer.
The therapy, currently known as MB097, is designed to be given to patients who have not previously responded to immunotherapy in addition to a checkpoint inhibitor pembrolizumab. MB097 was developed to reverse the drug resistance seen in these patients and is based on research looking into the gut microbiome of melanoma patients who do respond to this kind of immunotherapy.
The primary endpoint of the trial, which included 41 patients from the U.K., France, Italy, and Spain, who had previously shown resistance to anti-PD-1 drugs, was safety and tolerability of MB097. Several secondary endpoints including response rate, duration of response, and overall survival were also included. The therapy, which contains nine beneficial strains of gut bacteria, met both its primary and secondary endpoints in the study, according to the company, although precise details will be released at a scientific conference later this year.
“There is increasing evidence that the microbiome plays a crucial role in patients’ response to immune checkpoint inhibitors. Clinical benefit has been reported with fecal microbiota transplantations, while MB097 capsules taken orally each day affords an easy and reproducible way of modifying the microbiome,” said the national coordinating investigator for the study, Pippa Corrie, MD, PhD, a clinician and researcher from Cambridge University Hospitals NHS Foundation Trust, in a press statement.
“The MELODY-1 study results show that MB097 is well tolerated, with encouraging early signs of efficacy in a very difficult to treat metastatic melanoma patient population with primary resistance to anti-PD-1 based immunotherapy, in whom there is a significant unmet need.”
Up to half of all advanced melanoma patients fail to respond to anti-PD-1 immunotherapy, leaving them with very few options. A growing body of research, including a 2021 study showing fecal transplant can overcome resistance to anti-PD-1 immunotherapy, shows that the gut microbiome plays an important role in whether a patient’s immune system mounts an effective anti-tumor response when given these therapies.
The make-up of MB097 is based on detailed research looking at strains of bacteria linked to effective response to immunotherapy. Preclinical work showed that the bacteria in the therapy directly activate cytotoxic T cells and counter immunosuppressive tumor macrophages. If larger controlled trials confirm these initial results MB097 could become a standard add-on to immunotherapy.
Microbiotica has another clinical program in ulcerative colitis, which also reported good results earlier this year in another Phase Ib trial. In total, 63% of those in the treatment group achieved clinical disease remission versus 30% in the placebo group and all were also taking standard therapy for the autoimmune disease.
The company now plans to move both its programs to larger controlled studies with a view to moving closer to market approval with both therapies.
The post Microbiome Therapy Could Help Drug-Resistant Melanoma Patients appeared first on Inside Precision Medicine.

