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Measuring performance of middleware technologies for medical systems: Ice vs AMQP

After decades of design, development and usage of distributed application technologies, there are numerous communication middleware architectures and implementations in the market that have reached a considerable maturity level. A large number of them are open source initiatives that have shown efficiency and good performance in a broad range of domains, from banking to gaming. These are low cost solutions, easily programmable and of high interest to be explored in areas such as cyber-physical medical systems that have special requirements for safety, availability, communication latency, real-time operation, and fault tolerance. This paper analyzes the suitability of two open source communication middleware technologies, Ice (Internet Communication Engine) and AMQP (Advanced Message Queuing Protocol), as software elements suitable for developing audio transmission and reception systems for low cost medical applications. The paper simulates an audio application with both technologies, made of a server (nurse central) that receives and processes audio media from several clients (patients); communication can be triggered concurrent from multiple patients and in both directions. Stress tests with high load conditions are simulated in the experiments to show the behavior of both technologies mainly with respect to their stability and overhead.