Evidence from healthcare modeling: What is its nature, and how should it be used?

This paper summarizes an event which brought together modeling experts, users, potential users and healthcare management practitioners to explore the question of evidence in the field of healthcare: how it is, and how it should be, used. The paper is an abridged version of a full report on the event. The paper highlights the high status accorded to empirical evidence (generated, in particular by randomized controlled trials), and suggests that a more balanced view of evidence, as being composed of empiricist, rationalist, and historicist material, is of value. Modeling and simulation constitute sources of rationalist evidence. Tensions between different types of evidence are identified, and the tension between statistics and stories as evidential forms is explored. The paper concludes on an optimistic note: there are clear signs that within the UK National Health Service, modeling and simulation are being taken more seriously as sources of evidence.