Retained surgical items (RSIs) can lead to severe complications, and infections, with morbidity rates up to 84.32%. Computer-aided detection (CAD) systems offer potential advancement in enhancing the detection of RSIs. This systematic review aims to summarise the characteristics of CAD systems developed for the detection of RSIs, evaluate their development, effectiveness, and limitations, and propose opportunities for enhancement. The systematic review adheres to Preferred Reporting Items for Systematic Reviews and Meta-Analysis 2020 guidelines. Studies that have developed and evaluated CAD systems for identifying RSIs were eligible for inclusion. Five electronic databases were searched from inception to March 2023 and eleven studies were found eligible. The sensitivity of CAD systems ranges from 0.61 to 1 and specificity varied between 0.73 and 1. Most studies utilised synthesised RSI radiographs for developing CAD systems which raises generalisability concerns. Moreover, deep learning-based CAD systems did not incorporate explainable artificial intelligence techniques to ensure decision transparency.
Citation:
Chen, H., Cohen, E., & Alfred, M. (2025). Examining the development, effectiveness, and limitations of computer-aided diagnosis systems for retained surgical items detection: a systematic review. Ergonomics, 1–16. https://doi.org/10.1080/00140139.2025.2487558