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In March 2010 the US Food and Drug Administration (FDA) issued a boxed warning on the clopidogrel label emphasising that individuals with a reduced function CYP2C19 genotype are at an increased risk of adverse cardiovascular outcomes and advocating strategies for adjustment of clopidogrel dose or the use of alternative antiplatelet agents in these high risk individuals.15 In accomplishing the strategy of genotype guided clopidogrel treatment, the FDA subsequently approved a validated genotyping assay for detecting variant genes of CYP2C19 (AutoGenomics CYP2C19 Assay, 510(k) clearance received October 2010).

If you review your financial statements monthly, you may notice a $5,000 expense that a bookkeeper paid fraudulently but you are unlikely to notice it if the bookkeeper enters the expense into last month’s books, or last year’s books or the books from two years ago. You probably have enough to do already and don’t have time or the need to look at financial statements from previous periods.

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