If you're getting a misfire, you may feel it and/or your O2 feedback will go rich, throwing a code. Then you can put an IR gun on the exhaust manifolds, look at the spark plugs and test them with an HEI plug tester, do a cylinder balance test, Ohm out the plug wires, check cap and rotor, etc. Pretty much what you'd do when you get a cylinder misfire code but, you'd be looking at all of them instead.
There are scanners and computer programs that will tell you just about everything going on with your engine and controls too. Here's a couple examples;
TunerPro RT on an 88 1227747 ECM...
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EBL FLash-II WUD (What's U[ Display) on my 88, running Hiway Lean Cruise (for better mileage) note SA and AFR.
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The ODBI TBI ECM/PCMs aren't totally dumb, just didn't move on to Graduate School. Plus, you can Data Log (and play back) for as long as you want until you see what's going on when your issue occurs. Then you'll have an idea where to start.