Computerized detection of adverse drug reactions in the medical intensive care unit

► Little information is available on the performance of active medication monitoring systems in adult intensive care units. ► We evaluated five laboratory-drug combination alerts for detection of adverse drug events using an active medication monitoring system. ► Active medication monitoring systems that use laboratory-drug combination signals perform well in the intensive care unit. ► Laboratory-drug combination signals should be considered as part of adverse drug event surveillance systems in critically ill patients. ► The performance of these signals in the intensive care unit varies from other patient care areas.