These results document the extremely small magnitude of the relation between β-agonist use and death from asthma. These results specify that the relatioship between β-agonist use and death from asthma may be restricted to the delivery of β-agonists via the nebulizer. One article included in the meta-analytic integration was the Spitzer article published in 1992 which has caused great controversy in both the medical community and the popular press. This was the only one of the case-control studies included in this analysis to find an association between MDI-delivered β-agonists and death. The other studies included were based on a total sample of 1433 patients compared with the Spitzer study sample of 277 patients. The association of β-agonist use and death with nebulizer administration was felt to be related to nebulizer use marking the more severe asthmatic patients. Age was a significant predictor among all of the studies, even significant when the Spitzen data were eliminated. That study had the oldest mean age patients, possibly explaining why their study may have maximized the likelihood of observing a significant association between β-agonist use and death.
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