I argue that difference-making should be a crucial element for evaluating the
quality of evidence for mechanisms, especially with respect to the robustness of
mechanisms, and that it should take central stage when it comes to the general role
played by mechanisms in establishing causal claims in medicine. The difference-
making of mechanisms should provide additional compelling reasons to accept the gist
of Russo-Williamson thesis and include mechanisms in the protocols for Evidence-
Based Medicine (EBM), as the EBM+ research group has been advocatin