Uncertainty quantification (UQ) is critical for safety-critical domains like healthcare, yet it is rarely evaluated under realistic out-of-distribution (OOD) conditions. Here, we assessed predictive performance and uncertainty reliability for deep learning-based blood pressure (BP) estimation from photoplethysmography (PPG) signals under both in-distribution (ID) and OOD settings. Using an XResNet1D-50 trained on PulseDB and tested on four external datasets, we compared deep ensembles (DE) and Monte Carlo dropout (MCD) with Gaussian negative log-likelihood (GNLL) and mean squared error (MSE) losses, optionally followed by post-hoc recalibration via conformal prediction (CP), temperature scaling (TS), and isotonic regression (IR). The key findings of our study are as follows: (1) DE provides stronger predictive robustness under domain shift than MCD, an advantage that becomes clear primarily under external shift. (2) Recalibrated GNLL-based methods yield the best uncertainty calibration (e.g., GNLL+DE+CP for systolic blood pressure (SBP), GNLL+DE+TS for diastolic blood pressure (DBP)), while MSE-based uncertainty requires recalibration to become practically useful. (3) Across settings, CP and TS offer the most consistent gains, with IR remaining competitive in several cases. Overall, our results identify DE-based methods as most robust for predictive performance under domain shift, GNLL as strongest for native UQ, and recalibration as essential for making MSE-based uncertainty practical. These findings highlight the need to jointly assess predictive accuracy and calibration on external data for trustworthy cuffless BP estimation

For classification tasks, the performance of a deep neural network is determined by the structure of its decision boundary, whose geometry directly affects essential properties of the model, including accuracy and robustness. Motivated by a classical tube formula due to Weyl, we introduce a method to measure the decision boundary of a neural network through local surface volumes, providing a theoretically justifiable and efficient measure enabling a geometric interpretation of the effectiveness of the model applicable to the high dimensional feature spaces considered in deep learning. A smaller surface volume is expected to correspond to lower model complexity and better generalisation. We verify, on a number of image processing tasks with convolutional architectures that decision boundary volume is inversely proportional to classification accuracy. Meanwhile, the relationship between local surface volume and generalisation for fully connected architecture is observed to be less stable between tasks. Therefore, for network architectures suited to a particular data structure, we demonstrate that smoother decision boundaries lead to better performance, as our intuition would suggest.

In this section, we show that Cold Sampling is an approximation of the Euler method for (5). The intuition is as follows. B.2 Why is cold sampling better than naive sampling? Naive sampling does not have this property. The proof relied on applying definitions of Lipschitz functions twice.

Foreach trial, we choose 20 samples for training, 30 samples for validation and the remaining samples for test.

To address these issues, we introduce a novel Bayesian meta-learning approach called meta-variational dropout (MetaVD).