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The article shares insight on how the evidence of mechanisms help in evaluating the relevance of epidemiological studies for a single patient. Two hypothetical cases are addressed using the conceptual framework of evidential pluralism to illustrate the potential role of evidence of mechanisms. Examples are cited that illustrate different possible functions for evidence of mechanisms of confirming efficacy and disconfirming efficacy.

Is evidential pluralism possible when we move to the social sciences, and if so, to what degree? What are the analytical benefits? The answer put forward in this article is that there is a tradeoff between how serious social science methodologies take the study of mechanisms and the analytical benefits that flow from evidential pluralism. In the social sciences, there are a range of different approaches to studying mechanisms, differentiated by (1) the degree to which the 'process' is unpacked theoretically, and (2) whether the approach takes seriously the particular nature of social phenomena and the epistemological consequences that flow from this, as in realist approaches to the study of mechanisms, or whether more neopositivist-based foundational assumptions are adopted. Depending on which approach to study mechanisms is used, evidential pluralism is either: easy but superficial, very productive but challenging, or almost impossible because of the fundamental differences between the types of claims being made and the forms of evidence used. [ABSTRACT FROM AUTHOR]

Extrapolation of causal claims from study populations to other populations of interest is a problematic issue. The standard approach in experimental research, which prioritises randomized controlled trials and statistical evidence, is not devoid of difficulties. Granted that, it has been defended that evidence of mechanisms is indispensable for causal extrapolation. We argue, contrarily, that this sort of evidence is not indispensable. Nonetheless, we also think that occasionally it may be helpful. In order to clarify its relevance, we introduce a distinction between a positive and a negative role of evidence of mechanisms. Our conclusion is that the former is highly questionable, but the latter may be a trustworthy resource for causal extrapolation. [ABSTRACT FROM AUTHOR]