Numerous surveys show few patients realize there are clinical trials going on for what ails them, and even those who are aware are often leery of taking part. As a result, testing of genuinely new treatments has fallen behind, one reason that approvals of new drugs has slowed. A shortage of patients also means the quality of testing has suffered. That's because researchers are forced to widen the criteria that must be met for patients to take part, which often means the data collected is less definitive about whether the new drug works or is superior to existing treatments.

A survey of 6,000 cancer patients done for the American Association for Cancer Research found that 85 percent were either unaware or unsure that taking part in an experimental treatment was an option for them. However, 75 percent said they would have been willing to sign up if they'd known it was possible. As a result of this shortage in patients, 80 percent of cancer clinical trials being delayed.

There are generally three phases/stages of clinical trials. First, the FDA requires that any treatment first be tested to prove that it's safe in humans. These tests typically involve only a small number of volunteers, who may or may not be ill. Then testing moves on to demonstrate that the treatment has a positive effect on preventing or treating an illness at a certain dose, and that the effect is as good or better than the current standard treatment, or no treatment at all. Usually, researchers try to get from tens to hundreds of patients in these trials. Most study guidelines require that neither patients nor the doctor caring for them know whether they're getting the new drug or not. The third phase of a drug or procedure trial pits the new against the best standard treatment in several thousand patients, unless the disease or condition is rare.

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