Overall, a spontaneous reporting system (SRS) is better suited to detection of signals than an electronic health record (EHR)-based system, especially for certain types of reactions (rare events and those with a high drug-attributable risk).

Use of EHRs might be justifiable in some situations where SRSs perform poorly (e.g. outcomes with a high background incidence), provided that the additional costs can be taken into account.

SRSs and EHR-based signal detection systems can be complementary, the additional value of one to the other varying across events, as a function of the background incidence of the event.