Those calling for more evidence to support ever-increasing efforts to use information and communication technologies (ICT) in medical work argue that rigorous facts are necessary to make viable in practice substantiated use of these technologies. By contrast, socio-technical studies researchers, who focus on the use of ICT in everyday clinical practices, argue against the need for evidence produced under controlled, thus "unrealistic" conditions. Proponents of both positions, however, seem to operate with "a split reality," whereby they assume the "pseudo" can be readily distinguished from the "real," the "situated" from the "scientific." A comparative ethnographic approach can help mend this split reality approach. We compare how the same internet-based self-monitoring tool for asthmatics was used in a general practice setting and in a randomized clinical study, and thereby show how different effects were produced in these two settings. We propose that these effects are better conceptualized as enacting different assemblages of bodies, identities, and technologies, as opposed to creating either evidence or failed implementation.