Comparison 23. Adults ‐ Crossover design: All other inhaler devices vs pMDI (combined using SMD).

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 FEV1	32		Std. Mean Difference (IV, Fixed, 95% CI)	Subtotals only
1.1 Short term studies (min‐hours)	22	886	Std. Mean Difference (IV, Fixed, 95% CI)	‐0.03 [‐0.16, 0.10]
1.2 Cumulative dosing studies	10	422	Std. Mean Difference (IV, Fixed, 95% CI)	‐0.00 [‐0.19, 0.19]
2 FVC	18		Std. Mean Difference (IV, Fixed, 95% CI)	Subtotals only
2.1 Short term studies (min‐hours)	12	548	Std. Mean Difference (IV, Fixed, 95% CI)	‐0.05 [‐0.21, 0.12]
2.2 Cumulative dosing studies	6	298	Std. Mean Difference (IV, Fixed, 95% CI)	‐0.02 [‐0.25, 0.21]
3 PEFR ‐ Daily	12		Std. Mean Difference (IV, Fixed, 95% CI)	Subtotals only
3.1 Short term studies (min‐hours)	11	500	Std. Mean Difference (IV, Fixed, 95% CI)	0.00 [‐0.18, 0.19]
3.2 Cumulative dosing trials	1	62	Std. Mean Difference (IV, Fixed, 95% CI)	0.03 [‐0.47, 0.53]
4 PEFR (morning)	3		Std. Mean Difference (IV, Fixed, 95% CI)	Subtotals only
4.1 Long term Studies (days‐months)	2	78	Std. Mean Difference (IV, Fixed, 95% CI)	0.08 [‐0.36, 0.52]
4.2 Cumulative dosing trials	1	30	Std. Mean Difference (IV, Fixed, 95% CI)	‐0.04 [‐0.75, 0.68]
5 PEFR (evening)	2		Std. Mean Difference (IV, Fixed, 95% CI)	Subtotals only
5.1 Long term Studies (days‐months)	2	78	Std. Mean Difference (IV, Fixed, 95% CI)	‐0.26 [‐0.71, 0.19]
6 AUC‐FEV1	9		Std. Mean Difference (IV, Fixed, 95% CI)	Subtotals only
6.1 Short term studies (min‐hours)	8	444	Std. Mean Difference (IV, Fixed, 95% CI)	0.01 [‐0.18, 0.19]
6.2 Cumulative dosing trials	1	40	Std. Mean Difference (IV, Fixed, 95% CI)	0.07 [‐0.55, 0.69]
7 Heart Rate	10		Std. Mean Difference (IV, Fixed, 95% CI)	Subtotals only
7.1 Short term studies (min‐hours)	3	240	Std. Mean Difference (IV, Fixed, 95% CI)	0.13 [‐0.12, 0.39]
7.2 Cumulative dosing studies	7	222	Std. Mean Difference (IV, Fixed, 95% CI)	0.18 [‐0.08, 0.45]
8 Preference for inhaler	5		Peto Odds Ratio (Peto, Fixed, 95% CI)	Subtotals only
8.1 Short term studies (min‐hours)	2	112	Peto Odds Ratio (Peto, Fixed, 95% CI)	1.54 [0.73, 3.23]
8.2 Long term studies (days‐months)	3	150	Peto Odds Ratio (Peto, Fixed, 95% CI)	0.33 [0.17, 0.62]
9 Adverse Events	12		Risk Ratio (M‐H, Fixed, 95% CI)	Subtotals only
9.1 Short term studies (min‐hours)	7	256	Risk Ratio (M‐H, Fixed, 95% CI)	1.5 [0.64, 3.51]
9.2 Long term studies (days‐months)	2	78	Risk Ratio (M‐H, Fixed, 95% CI)	2.0 [0.39, 10.30]
9.3 Cumulative dosing studies	3	106	Risk Ratio (M‐H, Fixed, 95% CI)	0.86 [0.53, 1.40]
10 Serum K+	6		Std. Mean Difference (IV, Fixed, 95% CI)	Subtotals only
10.1 Short term studies (min‐hours)	3	199	Std. Mean Difference (IV, Fixed, 95% CI)	0.02 [‐0.26, 0.30]
10.2 Cumulative dosing studies	3	131	Std. Mean Difference (IV, Fixed, 95% CI)	‐0.29 [‐0.64, 0.06]