Clinician's Roundtable

Could metformin reduce risk of wet AMD development? Maria Berrocal, MD, speaks with Dimitra Skondra, MD, PhD, about a study published in Ophthalmology Retina finding that metformin exposure was associated with up to 30% lower odds of new-onset wet AMD. They discuss what the findings mean for patients with and without diabetes, where the protective effect appears to break down, and what a prospective trial could tell us next.

For anticoagulated patients with orthopedic or trauma fractures, delaying surgery to reduce bleeding risk may carry its own consequences. Join Dr. Charles Turck and Dr. John Scolaro as they explore how factors like surgical approaches, anticoagulation indications, comorbidities, transfusion-related risks, and physiologic reserve inform reversal decisions and discuss why multidisciplinary communication and timely intervention are critical throughout perioperative care and rehabilitation. Dr. Scolaro is an Associate Professor, Residency Program Director, and Chief of Orthopedic Trauma in the Department of Orthopedic Surgery at the University of California, Irvine.

With vaccination rates at historic lows and trust in public health institutions declining, primary care clinicians remain one of the most trusted sources of guidance for patients. Hear from Dr. Darilyn Moyer, Executive Vice President and Chief Executive Officer of the American College of Physicians, as she shares strategies for navigating difficult conversations about vaccines and preventive care.

How aggressively should you manage a vitreous hemorrhage after a PVD when you can't see the retina underneath it? Barton Blackorby, MD, moderates a discussion with Matt Starr, MD, and Kyle Kovacs, MD, about a study published in Ophthalmology by Hasbolat et al examining 366 patients with PVD-related vitreous hemorrhage initially managed with observation. The panel discusses how exam technique and B-scan reliance may affect detachment detection rates, debates follow-up intervals given that most retinal detachments in the study occurred within the first 3 weeks, and shares their own thresholds for moving to early vitrectomy versus continued observation, including how they counsel patients eager for faster visual recovery.

What happens when vitreous hemorrhage (VH) secondary to non-tractional PDR doesn't clear on its own? And does preoperative anti-VEGF actually change surgical outcomes? Maria Berrocal, MD, speaks with Sumit Sharma, MD, about a retrospective case series of 360 patients who underwent vitrectomy for non-clearing VH without tractional elements, examining whether preoperative anti-VEGF injection affects the risk of postoperative rebleeding, when to consider repeat vitrectomy, and how both physicians approach these cases in their own practices.

A study published in the Journal of the National Comprehensive Cancer Network examined follow-up colonoscopy rates after positive stool-based colorectal cancer screening tests, finding notably higher and faster completion rates with multi-target stool DNA testing compared to fecal immunochemical testing. These findings highlight the critical role of patient navigation in closing follow-up gaps and reducing disparities across racial and ethnic groups.

Joining Dr. Peter Buch to discuss their research and its implications for everyday practice are Dr. Mallik Greene and Dr. Jordan Karlitz. Dr. Greene is a health economics and outcome research expert at Abbott Cancer Diagnostics, and Dr. Karlitz is a volunteer gastroenterology professor at the University of Colorado School of Medicine and a Senior Medical Officer at Abbott Cancer Diagnostics.

Read the JNCCN study: Multitarget Stool DNA Versus Fecal Immunochemical Testing: A National Assessment of Follow-Up Colonoscopy by Race and Ethnicity

Noninvasive colorectal cancer screening is only effective when abnormal results lead to timely, high-quality colonoscopy, but recent data shows significant gaps in follow-up. Join Dr. Shelina Ramnarine and Dr. David Johnson, Chief of Gastroenterology at Eastern Virginia Medical School at Old Dominion University, as they explore how primary acre clinicians can set expectations with patients, address barriers to follow-up, and strengthen workflows and care coordination to close the loop.

Long-term effectiveness of colorectal cancer (CRC) screening depends on more than the performance of an individual test; it requires sustained adherence to recommended screening intervals and timely follow-up after abnormal results. But real-world data shows that many patients fall off track over time. Learn more about how we can improve adherence, reduce disparities, and strengthen continuity across the screening pathway as Dr. Brian McDonough sits down with Dr. David Lieberman, Professor Emeritus in the Department of Medicine and former Chief of the Division of Gastroenterology and Hepatology at Oregon Health & Science University in Portland.

Accurate IV medication delivery depends on more than proper pump programming alone. It requires a comprehensive understanding of smart pump drug libraries, dose error reduction software (DERS), infusion mechanics, and system-level safety procedures. To explore how these elements work together to support IV medication accuracy, patient safety, and clinical decision-making, Dr. Shelina Ramnarine speaks with Dr. Samuel Ubanyionwu, Medication Management Informaticist in Pharmacy Services and an Assistant Professor of Pharmacy at the Mayo Clinic College of Medicine.

Because patients with IgA nephropathy (IgAN) often have few symptoms early in the disease course, communicating the importance of treatment and its impacts on long-term outcomes can be challenging. Join Dr. Sayna Norouzi as she discusses practical communication techniques for explaining prognosis, setting expectations around therapy, and partnering with patients to support informed treatment decisions and long-term kidney health. Dr. Norouzi is an Associate Professor of Medicine and Clinical Nephrologist at Loma Linda University Medical Center in California. She's also the Founder and Director of the Glomerular Diseases Clinic at Loma Linda and Director of the GlomCon Glomerular Diseases Fellowship Program.