Five of 475 studies on surgical AI in poorer countries came from low-income countries

China

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The evidence base is heavily skewed towards early-stage development in a single upper-middle-income nation. Of the 475 studies, 305 came from China, and only five originated from low-income countries. Just 12 studies reported clinical deployment1, mostly as pilot projects for tasks like endoscopy image recognition or retinopathy screening. The authors note that artificial intelligence software models built in wealthy nations commonly underperform when transferred to poorer hospitals due to differences in population health, clinical workflows and data availability, and that limited adoption of electronic health records presents a barrier to local data collection.

Researchers reviewed the maturity and spread of artificial intelligence in surgical care across low-income and middle-income countries. A search of major databases identified 475 papers published up to July 2025. These studies were categorised by geographic origin, surgical specialty, study design, and stage of development to measure how many were in the development phase versus undergoing external validation2 or clinical deployment. Qualitative data from lower-income and lower-middle-income countries revealed what helps or hinders putting these systems into practice.

Grouping these nations as low-income and middle-income hides that clinical artificial intelligence is concentrated in one upper-middle-income economy. The systems described are mostly not running anywhere yet. A health system deciding whether to fund an artificial intelligence tool would need a count of how many of these systems are actually running in patient care.

Today’s links: Assorted links for 29 August 2026.

Footnotes

  1. Clinical deployment is the use of a software system in a real medical setting where its results are available to doctors treating patients. It is normally done to allow the software to inform actual medical decisions. ↩

  2. External validation means testing a software system using data from a different place than where it was created. It is normally done to check if the software works reliably for new groups of people. ↩

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