1. The French Association of Research in Thermalism - AFRETH - Christian-F Roques MD*, W Tabone **, R Rettig *** * Professor of Physical & Rehabilitation Medicine (Toulouse III University) President AFRETH scientific committee ** AFRETH General Secretary *** President AFRETH Administrative Committee PARIS

2. The AFRETH – Dec 2004 The origin : research an obligation in the convention SPA contractors – Social security 3 partners –The CNETH (contractors) –The ANMCT (spa resorts town councils) –The FTCF (french branch of the FEMTEC) 2 Committees –Administrative committee (strategy and financial decisions)(AC) –Scientific committee (scientific instruction and validation of the yearly call for projects)(SC) A budget –Functioning : 50000 € (CNETH, ANMCT, FTCF) –Investigation : 1,3 Million € (yearly)(CNETH 2/3, ANMCT 1/3)

3. Call for projects – results 1 (2005 + 2006) Pre- Projects EligibleComplete Projects Medical Service 342622 Security 433 Biology 733 Total453228

4. External expertal advices Clinical sciences22 Biological sciences8 Methodological sciences26 Economical sciences4 Medical ethics24 TOTAL84 The Health Department clinical trial analysis form

5. Scientific and material conditions of the clinical trials Well designed pragmatic studies –Relevance (doctors of spa resorts +++) –Randomisation –Accurate control population treatment –Criteria of judgement pertinent, validated, feasable –Size of the populations well calculated –Accurate statistics, … Ethically correct (french laws) Well organized and supported –Methodological support team (university) –Operating support team (investigating doctors, assessing doctors, clinical research assistants, …) –Good legal conventions previously signed Financially well-calibrated

6. Call for projects – results 2 (2005 + 2006) Pre- Projects EligibleCompl. Projects Scientif. Valid (SC) Financ. Valid (AC) Medical Service 34262288 Security 43332 Biology 73331 Total4532281411

7. Medical service Osteoarthritis of the knee (2 RCT) Venous insufficiency (RCT) Rheumatic diseases – a medico economic approach (pilot study) Children mucous otitis (RCT) Adults sinusitis (RCT) Overweight (RCT) Atopic dermatitis (RCT)

8. Others actions 2006 Meta-analysis of RCT on spa-therapy (INSERM) Expert consensus on methodology of clinical trials in spa therapy (Aix les Bains November 16th 2006) Scientific symposium on research in Spa therapy (Aix les Bains, November 17th 2006) AFRETH website : www.afreth.org

9. 2007 call for projects A) Medical service of Spa therapy in poorly investigated areas : dermatology, neurology,urinary tract, digestive tract, … B) News trends in SPA therapy : education, prevention, rehabilitation, ageing management, … in spa resorts C) Health security of spa therapy regular national survey : study of feasability (adverse effects collection and exploitation)