• Cerebral protection
• ventricular fibrillation
• EBM
• gene therapy

People can foresee the future only when it coincides with their own wishes, and the most grossly obvious facts can be ignored when they are unwelcome. Orwell

Risk communication has long been acknowledged to be fraught with pitfalls and subject to manipulation. The magnitude of harm and the publicity given to a risk can grossly sway perception of the problem. For example, risk of death from terrorism has a low lifetime probability of occurrence (well under 0.01%) but the harm is sufficiently clustered in time and space that it becomes newsworthy and therefore noted; in contrast, cardiovascular deaths have a high lifetime probability of occurrence (∼20–25%) but the harm is spread very thinly because each victim dies alone and out of the public eye.

Measures which are seen to be reasonable in preventing these varying classes of event have differing levels of acceptability. While it is widely considered acceptable to curtail personal freedoms to reduce the threat of rare but aggregated attack, restriction of personal choice of food in order to prevent the 2000 times more likely occurrence of cardiovascular disease (CVD) is almost universally considered unacceptable. The problem becomes amplified in primary prevention, where returns from intervention are low and accumulate over the long term, whereas the disutility incurred by forced lifestyle change or the side effects from drug treatment are immediate.