Professor Anders Perner helped launch Rigshospitalet’s platform trial initiative, designed to test several treatments at once and refine patient care as new evidence emerges.
If you are admitted to intensive care after a major accident, an organ transplant, or a life-threatening illness, the treatment you receive may still vary depending on where in the country you are hospitalized.
- These differences stem from habits, experience, and local culture – but in reality, we have introduced far too many treatments without sufficient evidence across hospitals worldwide. With INCEPT, we are testing the treatments we give to intensive care patients to find out what truly works best. And then we will align care across Denmark, says Professor and Senior Consultant Anders Perner from the Department of Intensive Care.
INCEPT stands for Intensive Care Platform Trial. It is a so-called platform study, meaning that it can evaluate many treatments both concurrently and over time. Anders Perner describes it as “an improvement engine" – one that keeps running and learning – with 19 intensive care units from across Denmark as well as sites in the Nordic countries, the Netherlands, and Switzerland all connected to the same system.
Putting chance to work
The first sub-trial investigates whether patients with acute circulatory failure (shock) benefit from receiving the plasma protein albumin. Albumin binds and transports substances such as fluids and drugs throughout the body, and low concentrations are associated with increased mortality.
- Albumin is a good example of how practices differ. Some ICUs use it a lot, others almost never. Both can't be equally right, says Anders Perner.
In June 2025, intensive care units at Rigshospitalet, Aalborg University Hospital, and Zealand University Hospital in Køge began documenting the effects and side effects of giving albumin versus not giving it.
- We randomize patients – about half receive the treatment and half don't. You could say we are systematizing chance so that we can learn from it. We continuously compare patient outcomes, and we will only stop the albumin arm in INCEPT once we know what works best, he explains.
Following the initial phase across the three hospitals this summer, the setup has been fine-tuned based on early experiences, and more Danish ICUs are now joining. During the autumn, new sub-trials will follow, including studies on atrial fibrillation (heart rhythm disturbances) and prophylactic anticoagulation dosing, the latter coordinated by colleagues in the Netherlands.
The system is learning to benefit the patients
Together with the Capital Region of Denmark's Center for IT and Medical Technology (CIMT), the INCEPT team has built a dedicated IT system to randomize patients, collect data, and enable continuous analysis of treatment effects.
- When testing a treatment, we randomize patients so that half receive it and half don't. With the system's help, we analyze results in real time. If one treatment appears to work better, more and more patients are shifted toward it – while the trial continues until we are confident in the effect. These adaptive, learning elements ensure that patients already benefit while the study is still ongoing, says Anders Perner.
The success criteria for INCEPT were defined jointly by a large group of patients, relatives, researchers, and healthcare professionals. Together they agreed that the key measures of success are survival, shorter time on ventilators, and returning home with good quality of life and cognitive function.
- Wrong or excessive treatment can have huge costs – both for society and for the individual patient. I believe platform trials can make a massive difference, not only in using resources wisely but, most importantly, by ensuring that what we do is based on solid evidence, says Anders Perner.
Platform trials was also on the agenda when healthcare leaders from across Europe met in October 2025 for the Copenhagen Life Science Summit to discuss the future of European healthcare systems.