Science is aimed at universal knowledge. Art is aimed at action for solving
concrete and local problems. Can medical practice therefore ever be a scie
nce even when employing important aspects of scientific practice such as pr
ecise concepts and vocabulary, and a demand for well-validated facts togeth
er with rational reasoning? Evaluation of medical and clinical practices in
general has an ambiguous status. According to the domain to be evaluated,
it can reach a level of science in providing results of universal value but
more often it is closer to art, the results remaining of local interest. T
here is no strict correlation between the universal-local axis and the prac
tical interest for public health. Epidemiologists should consider these mat
ters very seriously and aim to contribute to, rather than discard, their si
gnificance for the advancement of clinical practice.