When monitoring spontaneous reports of adverse reactions to registered
drugs, it is important to detect any change in the number of reported
adverse reactions in the course of time. Sales adjusted adverse drug
reaction rates are usually compared in order to be able to take drug e
xposure into account. Here we review the so-called arithmetic and some
statistical procedures which could form the basis for an alert system
. The advantages and disadvantages of each of these methods are discus
sed. The importance of data requirements and the problems which arise
when using an alert system are pointed out and then clarified with the
help of the example of diphtheria/tetanus vaccine.