The pressures of ethics and equity on clinical trials have always been severe. The highest level of evidence about the usefulness of therapy is that obtained from well-planned, carefully conducted randomized, and where possible, double-blind clinical trials. Traditional frequentist statistics have been used predominantly, but a Bayesian approach may offer more flexibility by leveraging more information from the results of a clinical trial. Innovative designs can minimize the number of patients included in a trial and decrease the chance of maintaining a patient in an unfavorable treatment arm.