Predicting the future, so as to direct it towards the most favourable position, is the aim of all medical activity. Technological advances are providing new tools, with the aim of identifying subgroups of people that are at higher risk and for whom the more aggressive procedures are, undoubtedly, desirable. The current challenges are to better define the sub-groups, to propose procedures proportionate to the risks and to move on, as quickly as possible, from assumptions to structured programmes of care.