Contextual evidence in clinical medicine and health promotion.

The randomized clinical trial (RCT) and systematic review underpin evidence-based medicine. They are perceived to provide the strongest evidence on interventions—when viewed as part of an evidence hierarchy, and are generally accepted as such, in clinical medicine. Yet, they are perceived to have limited currency in health promotion practice. Those trying to build bridges across these fields have often been challenged as to whether or not the RCT is the design for both. We argue that ‘real life’, including decision making and practice both in clinical medicine and health promotion, requires contextualized evidence; that integrated research on outcome and context is feasible and desirable, both in clinical medicine and health promotion; and that these fields could learn from each other’s approaches towards contextualization of evidence.