[Levels and criteria for evaluation of primary preventive interventions and their relevance for the cholesterol...

Before medical interventions are implemented, they should be evaluated for their effectiveness, benefit and acceptability. The effectiveness of a measure does not guarantee its usefulness. And even the proof of a benefit, although an indespensable precondition, is not always sufficient for the intervention's acceptability. A decision about the latter can only be the result of a complex ethical discussion. Acceptability is the most important criterion and overrules effectiveness and benefit during evaluation of a treatment. More stringent criteria than those for the evaluation of therapeutic actions must be used for primary preventive interventions, because these relate to healthy people. When various criteria for the evaluation of extensive cholesterol prevention are used in light of the previously mentioned analytical levels, one must conclude that the particular intervention is not warranted.