Validation of deep learning models for cuffless blood pressure estimation on a large benchmarking dataset

Objective: This study aims to evaluate the effectiveness of deep learning techniques in estimating cuffless blood pressure (BP) across a diverse patient population in intensive care units (ICUs). Methods: A comprehensive ICU benchmarking dataset encompassing 2,154 patients with a wide demographic range (18-97 years old) and varied cardiovascular status was employed to validate several deep learning models in predicting continuous BP waveforms. Three methods were developed to enhance the model's generalizability to this heterogeneous dataset. Ten-fold subject-independent cross-validation was performed and the model performance was assessed through mean absolute error (MAE), Pearson’s correlation coefficient (PCC), and compared with significance analysis. Results: The UTransBPNet_Demo_In model, which incorporated demographic and physiological signals as inputs, achieved a PCC of 0.89 and a MAE of 10.38 mmHg in predicting arterial BP waveforms, demonstrating the highest tracking capability among all models. Notably, the performance of UTransBPNet_Demo_In remained robust across variations in demographic and cardiovascular status. Conclusion: The UTransBPNet_Demo_In model demonstrates robust predictive capabilities across a broad spectrum of demographics and cardiovascular conditions. Although the performance still needs further improvement, this study offers a benchmark in the field of cuffless BP monitoring in critical care settings for future studies.