Assignments of meaning in epidemiology.

Epidemiology works in a public domain, gathering the results of surveys and trials into forms of knowledge which are made available to many stakeholders. Health policy makers, lawyers, the media, medical technology companies, and those who use and deliver health services all have legitimate interests in epidemiology. There is unfortunately no common language in which each of these stakeholders can express their interest in the outcomes of epidemiological studies. The largest and most important gap exists between those who use computational data and those who use cultural and linguistic models to generate their explanations. Methods have been described, however, which allow the identification of all legitimate stakeholders before epidemiological studies are undertaken. Identifying the stakeholders, however, will serve no purpose unless there is a prior commitment by epidemiologists to respect both reductionist and narrative accounts of truth.