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The Internet can connect patients looking for treatments with investigators looking for research subjects-a benefit for both sides, and for the advancement of science. But our suvey of the Web trials search scene today indicates it's also changing the roles of all involved, in ways they would not have expected. Before the Internet, patients usually found out about clinical trials from their doctors. Today, more and more people are logging onto the Internet and, within a few clicks, pulling up a list of trials being conducted at nearby hospitals and universities. The potential benefit for patients is tremendous. "People with rare diseases historically have had a very hard time finding out if anybody is doing any research on their disease," says Abby Meyers, president of the National Organization of Rare Disorders, a patient advocacy group based in Danbury, CT. Over the past 10 years, several hundred sites have sprung up to help pharmaceutical companies, government agencies, and private research foundations recruit patients for trials. Most of them allow a patient to search for trials by disease, geographical location, and other parameters, as well as browse through lists of medical conditions. Some of the sites are for-profit, while others are run by patient organizations or the government. Some focus only on one type of medical condition, such as cancer, while others list trials for a variety of conditions. Traffic to these sites has increased at a steady pace each year, says Daniel McDonald, vice president of Thomson CenterWatch, a company that, in addition to providing one of the largest clinical trials databases on the Net, tracks trends in how investigators and patients are using such Web sites. About 7 million people searched for trials on the CenterWatch site in 2004, and traffic to the site has increased 25% to 30% every year, says McDonald.