[Towards evidence-based public health?]

Evidence-based public health can be viewed as a way of facing community health problems by which the decisions are taken accordingly to the available evidence. A complete multidisciplinary approach should be introduced, with the goal of identifying and articulating the different dimensions which are present when trying to respond to the challenges or problems for the people's health. In addition to clinical medicine, disciplines such as epidemiology, biostatistics, health services research, economics, behavioural sciences, demography, nutrition, gerontology or computing sciences, among others, may contribute to health promotion and disease prevention. This open approach should not be exempt of a captious attitude toward the obtainable information, while it is essential to have a comprehensive spirit to combine this information with the previous experience and the peculiarities of each situation. Searching for evidence begins with a clear operational statement of the problem. This helps to select and obtain the key pieces of information. The information obtained must be judged critically, and related to the specifics of the problem. Lastly, it should be accepted that search for evidence does not mean finding certitude. Idolizing evidence can end up being as inappropriate as the implementation of a health program ignoring the previous information about its potential effectiveness, if such information were available. Many decisions in public health have to be taken conscious that scientific evidence does not rule out uncertainty, as other elements such as the cultural context, the individual preferences and other social factors may have a decisive influence in the success or failure of public health interventions.