Evidence and Computer Simulations in Public Health

Abstract In the last decades, the evidence-based approach has become dominant in the biomedical sciences. Its influence has extended from clinical practice to other areas such as drug regulation and public health. Nonetheless, given the limitations of the evidence-based framework, a more pluralist approach towards evidence has been demanded. In this sense, evidential pluralism holds that evidence of mechanisms should complement statistical evidence. This paper aims to explore and discuss the prospects of evidential pluralism in public health. First, we will analyse the evidential standards of the International Agency for Research on Cancer. Those standards are argued to be in line with the pluralist approach. Second, we will consider the main challenges for gathering evidence of mechanisms in public health. For that purpose, diverse types of evidence of mechanisms will be identified. And third, we will assess the role of agent-based models as mechanistic studies. Based on a case study, we will discuss whether agent-based models can provide evidence of mechanisms and mitigate the abovementioned challenges.