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A licensed provider makes the final clinical determination

This was supported in a post hoc analysis of SAVOR TIMI 53 participants showing that exposure to metformin did not significantly affect cardiovascular outcomes in patients with to severe CKD (19)

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Scand J Stat 6:6570 Pinheiro JB, DebRoy S, Sarkar D, R Core Team (2017) Linear and nonlinear mixed effects models

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Finally, the PLB dosage and administration strategy should be refined, and its long-term effects and potential side effects should be comprehensively evaluated to confirm its safety and effectiveness in clinical applications