Putting Doping to the Test

by Rant on September 3, 2009 · 26 comments

in Doping in Sports

Over the past few days, I’ve had an interesting discussion via email with one of RYHO’s regular readers. We’ve discussed the idea that perhaps some organized experiment might be in order, so that the actual effects of various doping agents can be gauged.

Over the years, WADA’s list of banned substances has grown longer. Some of the drugs on their list are no doubt performance-enhancing in some way. Some of the drugs on the list are thought to be masking agents, which someone somewhere has suggested might be used to cover up an athlete’s use of performance-enhancing drugs or techniques. It’s not always clear whether any real scientific research exists to back up the conjecture that substance X is performance-enhancing or is an effective masking agent. Perhaps it’s time to put things to the test.

Given that even the most well-funded anti-doping agency we can imagine wouldn’t have the funds to test every athlete for every conceivable drug that theoretically could enhance the athlete’s performance, it seems reasonable to take a more focused approach. Like actually determine those drugs (and techniques) that produce a measurable performance improvement. Having assembled that list, then the task becomes much more focused, and one hopes, a better, more targeted use of the ADA’s available resources.

Keith “mitakeet” Oxenrider fleshed out the idea for an experiment to determine what drugs really are performance-enhancing. What follows is his proposal.

A Radical Proposal

by Keith “mitakeet” Oxenrider

I am looking to gauge interest in the idea of doing a serious large-scale study on performance-enhancing drugs (PEDs) with an eye toward learning if they are in fact performance-enhancing, determining the false positive and false negative rates for various anti-doping tests and any placebo effects that might exist. In addition, the experiment would seek to determine which masking agents currently banned by the World Anti-Doping Agency successfully hide an athlete’s doping and which do not. While certainly an expensive study to get any sort of meaningful statistical results, it seems to me that there may be many stakeholders in the arms race between PED users and detectors that would be willing to fund such an experiment.

The basic outline of what I have in mind is to get at least 100 professional cyclists (cycling seems to be most prominent in the media with respect to PEDs, though the results should be applicable to any other sport) hired specifically for this testing and paid their normal salary. The duration would be at least a year. The experiment would be double blind so no one would know who was taking what until the experiment was concluded. Each athlete would be given the same series of pills, patches, injections, and so forth on the same periodic basis, but most of the pills, patches, injections, etc. would contain no performance-enhancing drugs. Each athlete would fill out a survey indicating how they feel (i.e., do they think their performance is being enhanced) as well as how they think their compatriots are doing. Each athlete would be regularly tested for PEDs with parallel samples being sent to accredited drug testing labs as well as testing in-house. To encourage the athletes to take the project seriously, competitions would be scheduled with prizes calculated to be high enough to motivate their performance without being high enough to motivate them to add any possible personal PED cocktail.

If a particular drug is actually performance-enhancing there should be a crystal clear increase in each individual’s performance when taking the drug as compared to their baseline, and ideally the survey results will correlate well with the results. Since who has taken drugs and who hasn’t will be documented it should be possible to formulate very accurate false positive and false negative rates, something that has been difficult to determine from information available through the World Anti-Doping Agency and its affiliates. Because there will be records of who used which PEDs and when those PEDs were used, it weill be possible to gauge the ability of the existing drug tests to accurately detect doping. And by looking at masking agents it will be possible to gain an idea of what really works and what doesn’t work to hide the use of PEDs. Most importantly, by doing this as an independent entity the study design, raw data, results and conclusions will be in the public domain and available to all researchers on PEDs (and, of course, to those who might consider the use of PEDs to help their performance, but such is life).

Such an experiment will also be able to gauge the placebo effect, since other than knowing that they will be using PEDs at some point during the experiment the athletes won’t know when they actually were given those PEDs. As such, their self-reported survey results should serve as an excellent control for the placebo effect.

A study of this magnitude would likely cost $20 million (US) or more. If, say  $50,000 is set aside to pay each of the professional cyclists (though it might be instructive to allow interested parties to join for less as a way to increase the number of participants) then the salary just for the cyclists would be $5 million.There needs to be more than just cyclists to complete this experiment. In addition to the cyclists, the group as a whole will be organized into teams with team directors and the typical support staff. There will be several dozen scientific staff, as well as access to a well equipped laboratory for in-house testing. And there will be the cost of sending the samples to the accredited labs.

Also, a good pharmacy will be needed to produce the testing material and track the drugs so when the scientists un-blind the study there will be accurate data to work with. Of course, such an experiment will need statisticians to ensure the experiemental design is correct and to analyze the results when it is done. To pay for such a study funding might come from such research entities as the National Institutes of Health and the National Science Foundation, as well as various interested commercial entities. Perhaps even the UCI, USA Cycling and the US Anti-Doping Agency might chip in some money. It  seems to me that there should also be substantial interest outside the US (particularly in Europe) which might translate into willingness to offer their financial support.

Of course, there are some potential drawbacks for the athletes that will need to be resolved. Since they will clearly be taking PEDs at some point in the experiment some mechanism needs to be in place to ensure that their ability to legally compete won’t be compromised. While the use of paid amateurs might result in useful data, professionals are used to the dedicated pounding on their bodies and I expect would have a lower drop-out rate than amateurs. Using non-athletes will not get us the best results, because we specifically want to see the impact of the PEDs on well-trained competitors, and thus we need people with an extensive history of pushing themselves to their limits in competition.

A limitation of this study would be its relatively short-term nature. It won’t be practical to cycle through all the common PEDs and look at their long-term impact as well. It might be possible to examine some common (or thought to be common) cocktails of PEDs, but it won’t be possible to examine every conceivable combination. Certain drugs might be deemed potentially too dangerous and certainly there will be dosage levels that will be considered dangerous and we won’t want to intentionally put any athlete’s health at risk. As such this experiment won’t be able to answer all questions to everyone’s satisfaction. There will need to be a consensus on what we test and the utility of the tests we do run for the results to have merit. A primary purpose of doing all this with input and review of the public is to get the best results possible with the least expense.

Since this is intended to gauge interest, if you have influence in the PED world and are willing to lend it on behalf of an experiment like this please let us know. If you think that this outline can be fleshed out please add your comments. If you have a well thought-out argument against this experiment we would like to know. Most any proposal can benefit by some thoughtful discussion by people on various sides of an issue, including a hot-button issue like doping. Anonymous comments are welcome, too, for those who might have a story to tell or question to ask, but who don’t want to publicly identify themselves.

R Wharton September 3, 2009 at 9:54 pm

Well, I’m not a pro cyclist, but I am a cycling professional. Sign me up. I’ll guinea pig it for you. I even have about 10-15 years of blood and more recently, wattage, data, to help you wholistically.

Thomas A. Fine September 3, 2009 at 10:31 pm

The best argument against this can be summed up this way: not in a million years.

Even if money was magically not a problem, this would be just too much of a political hot potato for anyone to touch.

Which is too bad, because I’d love to see it happen.

As far as the placebo effect, I’ve often wondered if PEDs get a double placebo bonus. There’s the power of positive thinking on race day and in training too. But I think that most athletes would also do a better job of training on PEDs than off. Imagine you’re a pro athlete who’s decided to try PEDs, knowing the risks, and paying a ton of money. That’s not a time to skimp on training, or you’re just wasting your investment. Suck it up and train the full six hours in the rain, because the PEDs don’t work if you don’t.

tom

mitakeet September 4, 2009 at 6:02 am

Hey Tom I think you may have hit the nail on the head, at least in my opinion. I think the placebo effect is so powerful that people ‘doping’ go the extra mile (or extra hour in the rain 😉 just as you say. I recall a strip from Tank McNamara years ago where a couple of researchers were injecting a guy with distilled water and were amazed to see how much better he performed. Since everyone is looking for an edge, getting grape seed enemas might be just the thing if you either implicitly trust your advisor or somehow have bought into grape seed extract as being the cure for all ills.

R. Wharton, what is the distinction between your being a “cycling professional” but not a “pro cyclist”? Other than wishing I had time to bike a century a day (and in particular being in the kind of shape where one can bike a century a day) and watching a lot of the TdF, I can’t say I know much about the ‘biz. In your opinion (as a cycling professional), is $50K/year silly high, embarrassingly low or right on the money to attract people who expect to put in 30-50K miles/year on their bike?

Thanks for your comments! If you know of other people who might be interested in my ‘radical proposal’ please point them here so we can get their input.

Cub September 4, 2009 at 9:03 am

A lot of drugs will have noticeable side effects even if they have no performance enhancing effect. The subject will know he is getting something other than a sugar pill or saline injection, and that can affect his performance and/or perception. It’s very hard if not impossible to design a study that accounts for this.

Larry September 4, 2009 at 9:25 am

Umm, mitakeet, you can’t be serious. Right?

First off, you’re talking about testing pro cyclists. These are people who, by definition, make their living riding their bikes. They are not going to jeopardize their ability to make a living by participating in your study. True, you propose to pay your study participants one year’s normal salary. What about when that year is over? If you plan to reveal who the dopers were in your study, then these riders will be stigmatized for the remainder of their careers. If you don’t plan to reveal who was doping and who was receiving placebos, then everyone in your study will be suspected of doping. Moreover, give up any idea that you’ll be able to keep your study results confidential, or that any cyclist will believe that you can keep these results confidential. We have too much recent evidence that PED testing results cannot be kept secret.

Second: even if you can find 100 pro cyclists dumb enough to participate in your study, WADA would never go along with it, and neither will the community of cycling teams, UCI and the race organizers. Your plan would force the cycling community to acknowledge that a number of riders are racing with PEDs AND CAN GET AWAY WITH IT, at least for a year. You will take a sporting competition like the Tour de France and turn it into a lab test. Who would want to attend such a race? Who would want to sponsor it? You are proposing to flush a year of pro cycling down the drain.

Third: you are failing to consider that some pro cyclists are ALREADY using PEDs. They are not going to abandon their PED regimens to participate in your study, where they’ll either receive a potentially inferior mix of PEDs, or no PEDs at all. So either these dopers will continue to use PEDs in addition to the ones you give them, or they’ll refuse to participate in your study. Of course, you may be planning to exclude PED users from your study – but how do you plan to detect them? You can’t rely on the existing doping tests, as we know that these tests do not catch all of the dopers. You write that race competitions would need to have prizes not high enough to motivate riders to use additional PEDs, but this is not possible. Cycling amateurs are motivated to use PEDs, too.

Fourth: there are a number of cyclists out there who race clean, and are proud of it. They’re not going to want to participate in your study, either. Sure, there are a few riders out there who might think that the scientific benefits of your study outweigh their personal interest in being a clean rider. (If there are, then don’t show them what I’ve written here!) But most clean cyclists won’t feel that way. Remember, you’re trying to prove that so-called PEDs actually improve performance. In my experience, no one I’ve met in cycling questions whether PEDs improve performance, and I doubt that any clean cyclists will be willing to become dirty in order to prove what they think they already know.

Fifth: your study has serious ethical problems. Some of your PEDs are potentially dangerous drugs. Some of your PEDs are only approved for use by patients with particular medical conditions. You are asking athletes to endanger their health in order to engage in this study. You yourself acknowledge that certain PEDs might be considered dangerous, but you’re dramatically underestimating your problem: nearly all PEDs are considered potentially dangerous, and the ones we’re most interested in (steroids, testosterone, EPO, etc.) are certainly considered potentially dangerous. Besides, you’re asking the wrong question: it’s not whether the drugs are “potentially dangerous”, it’s whether the drugs are considered to be safe. So, even if you can satisfy your own sense of ethics, and the legitimate health concerns of your study participants, you probably will not get past the legal restrictions against performing this kind of testing.

Sixth: even if you can overcome the obstacles mentioned above, your test has no scientific validity. You are trying to compare the performance of athletes before and after their use of PEDs. You are proposing that you measure the athlete’s “baseline” before and after they take your regimen of PEDs (or placebos), to see the effect of using PEDs. It won’t work. (a) As I pointed out above, you’ll never know whether an athlete’s “baseline” was affected by his undetected use of PEDs outside of your study. (b) Any change in an athlete’s performance after use of your PEDs/placebos could be affected by any number of factors falling outside the scope of your study, such as aging, injury and differences in race conditions from year to year (weather, team tactics and support, etc.).

Sorry, mitaket. Your study just won’t fly.

Cub September 4, 2009 at 9:50 am

Poor mitakeet is being subjected to something that the anti-dopers don’t have to worry about – effective peer review where rather than patting him on the back and telling him how brilliant he is, we try to rip his ideas to shreds. 🙂

Lsrry September 4, 2009 at 11:50 am

Cub, THAT’s funny.

Actually, on this site we rip everyone to shreds. It’s just poor mitakeet that has to listen.

mitakeet September 4, 2009 at 12:13 pm

Larry I am serious, but I don’t really expect anything to come from this. However, I learned a very long time ago that not asking (or proposing, in this instance) essentially guarantees that nothing will happen and I have been very surprised many times that questions I _knew_ the answer to turned out, in reality, to be the opposite of what I expected. I would actually be disappointed if I got no negative feedback as it would convince me no one was taking the issue seriously.

1) Clearly the issue of how the participants are treated by any anti-doping agencies will have to be unambiguously worked out before anything could proceed. One of the reasons I propose getting enough funding for an entire season is because of the expectation that they won’t be allowed to compete for some period after the experiment. Since doping offences do not (currently) lead to life-time bans it seems reasonable to me that some sort of deal can be worked out such that the participants are allowed back into professional cycling. Perhaps we might need to cover then for an additional year or something, but that is the point of paying them their full professional salary. I am not sure why you think they would be stigmatized for the rest of their career for participating in an open experiment. These people won’t be cheating and won’t be participating in any competitions. Even blood doping, to my knowledge, is considered a short-term process and only things like steroids are considered a long-term performance enhancement. By the end of the experiment none of the participants should be subject to any lingering enhancement.

2) I am not suggesting that any of the participants involve themselves in any sanctioned activities, rather the exact opposite. I am proposing that they compete amongst themselves in events setup solely for the purpose of the experiment, so there shouldn’t be any impact on sanctioned races beyond, possibly, driving up the costs of the domestiques for a season.

3) Clearly there won’t be any way to guaranteed that participants are dope-free. However, because no one would know what they are getting or when they are getting it it would be rather reckless for someone to join such an experiment intent on gaming the system. Disclaimers would have to be quite clear on that.

4) “In my experience, no one I’ve met in cycling questions whether PEDs improve performance”. Based on the information gleaned from the Landis discussions I feel that there is substantial question about whether PEDs improve performance beyond the placebo effect. The long laundry list of drugs that, even in microscopic amounts, that are purported to change a domestique into a world champion is jaw dropping to me. How can taking cold medicine suddenly make someone ride several percent faster? As a biochemist who knows a couple of things about metabolism, the claims of what is performance enhancing amounts is just plain silly. The idea of having zero tolerance simply because there might have been some performance benefit is to condemn people without cause (which is what seems to be happening, though I am sure the Landis reporting I read makes my awareness biases). The idea of this experiment is to attempt to define what, exactly, is performance enhancing and what is just plain nonsense that is ruining people’s careers for no reason whatsoever.

5) Ethical questions clearly need to be resolved, but by having trained medical professionals using pharmacy approved drugs should go a very long way to minimizing any inherent danger in the experiment. Clearly just riding a bike on public highways is dangerous so it won’t be possible to create experimental conditions where there is no possible source of harm. The incremental increase in harm potential would have to be evaluated by qualified scientific/medical professionals and all potential participants would have to have a clear understanding of what is going on. Getting people to volunteer to be paid guinea pigs might not be the challenge you think it is as I know from personal experience through a vaccine research laboratory. Healthy people are always subjected to the initial medical testing of any new drug or vaccine, this is no different except it isn’t really new and in this case I am specifically targeting professional cyclists.

6) Regarding scientific validity, I am quite sure the experiment can be designed to provide clear and meaningful results if we can get 100 participants. The ‘baseline’ isn’t what happens before or after the experiment; it is what happens when we know they aren’t being subject to PEDs. I envision something like a few days of PED treatment a month and the rest of the month with nothing then repeat with some different PED. It is the variation in their intra-month performance that I am interested in and only when correlated with all the other participants taking the same PED. While I don’t claim to be any sort of qualified professional to ensure that the proposed design is free from any biases or distortions, I have read enough medical experimental protocols and been a scientist long enough to know that with the number of participants under discussion we will have very clear and unequivocal results if the PEDs tested are in fact performance enhancing.

Regarding Cub’s comment about participants knowing they are getting a treatment, this is a well-known issue and I am sure that there are well-known remedies. It is something that needs to be addressed, but by professionals in the art of designing double-blind studies. I am hoping that this post can interest some of those professionals into joining an effort to make this happen.

Thanks for your well thought-out responses and I appreciate the time you take to respond.

Mitakeet

Larry September 4, 2009 at 3:17 pm

Mitakeet, I’ll respond by the numbers:

1. I think there is no question that the participants would be stigmatized. One person’s opinion, perhaps. But look at David Ortiz, who purportedly failed one drug test 6 years ago, and has been positively pilloried in the Boston press and elsewhere. The doping stigma does not seem to go away. If I were an athlete, I would not take the risk that participating in your study might permanently damage my public reputation.

2. I now understand that you are expecting your study participants to remove themselves from the current pro cycling scene for a year. No one is going to do that. Athletes have short careers. Moreover, you cannot create artificial events for your athletes that would realistically mimic the events they’d otherwise participate in on the pro tour. For example, how would you set up your alternate Tour de France? The French would not cooperate, and you’d get no sponsors. Your study could not afford the cost of conducting a shadow pro tour.

3. Why wouldn’t your study participants want to take supplemental PEDs? Aren’t you proposing to pay them more if they win? If not, then how do you expect to set up a realistic shadow pro tour?

4. You misunderstand me. I’m not saying that I believe that all PEDs enhance performance. In fact, I personally believe just the opposite, and I have argued this point here against those who believe that the effectiveness of PEDs is proven merely by their popularity. If we’re looking at cycling, then I think that a number of so-called PEDs probably do NOT enhance performance. My point here is that my doubts (and yours) on the effectiveness of PEDs do NOT appear to be shared by those in pro cycling. In that world, it seems to be taken as a given that most or all PEDs ARE effective. So I doubt that you’re going to find a lot of people in pro cycling who are willing to make sacrifices to see the results of your study.

5. Regarding ethics, I don’t think it matters that a drug is “pharmacy approved”. You are talking about drugs being used for purposes other than those for which the drug was designed and tested, and there is potential for danger in this kind of drug use. A good deal of conventional drug abuse is abuse of pharmaceutical drugs. As for whether you can safely administer these drugs … well, you probably CAN do so (see the study cited below), so long as you’re careful, but if you do so you might not replicate the way PEDs are used by athletes in the real world. Moreover, I think that medical ethics would demand at minimum that the folks receiving PEDs were properly informed and that they consented to receive the PEDs. Again, please see the study cited below.

6. Based on your last post, I now understand that you propose for your PED users to use PEDs only part of the time, and that your “baseline” for these users would be measured when they weren’t using PEDs. Unfortunately, that kind of baseline doesn’t really work. PEDs are not only used for short-term purposes (i.e., drugs taken on day 1 to enhance performance on day 2). They are also taken during an athlete’s training season to allow for more effective training, thus enhancing performance for an entire racing season. But consider this more carefully. There are two possible ways to do this kind of testing: in the lab, or on the road. In the lab, you can more precisely control for what you’re trying to measure (for example, peak power output, or VO2MAX). But you’ll never know whether the stuff you’re measuring in the lab really translates to better performance on the road, and even if you strongly suspect that a measurement like VO2MAX must relate to road performance, you’ll never know the extent of the difference it makes in the outcome of a race. However, if you run your test on the road, you’ll never be able to control for all of the factors that go into a better performance, such as tactics and strategy, a stronger team, better race conditions, and so forth. For example, say that rider A had a poor climb of Alpe d’Huez without PEDs at the beginning of your mock Tour, and a good climb of Mt. Ventoux using PEDs at the end of the Tour. So? There could be 100 reasons for this difference in performance having nothing to do with PEDs.

Mitakeet, I don’t know who you are or what your expertise might me. There HAVE been studies trying to show the effectiveness of PEDs. For example, please see the study discussed at http://www.sportsscientists.com/2007/11/effect-of-epo-on-performance-who.html. Of course, these studies are performed in labs, on people who are not elite athletes, so they are far from perfect. Still, I think that these studies provide an interesting model. For example, I’d be fascinated to learn what effect EPO might have on the peak power output of Tour riders.

Mitakeet, I appreciate the effort you put into designing your study, and I agree with you that we need more information on the performance-enhancement that is possible with PEDs. I just don’t think your study is going to get us there.

eightzero September 4, 2009 at 4:24 pm

I can’t imagine any IRB approving a protocol for such a trial. I’m note sure I can categorize the benefit, but the risks sure seem significant.

This is fun to think about in the abstract though.

eightzero September 4, 2009 at 5:07 pm
mitakeet September 4, 2009 at 8:02 pm

Hey Larry, thanks again for your thoughtful answers.

I appreciate the link and the results are impressive on the surface. Laboratory testing is great for helping to guide ‘real world’ studies, but should not be considered a substitute for such studies. My proposal is to conduct such ‘real world’ studies in an attempt to separate wheat from chaff. Whether EPO winds up on the list to test would be up to experts in the field, not the likes of someone like me. If there is a scientific/medical consensus that a given PED is in fact performance enhancing then it seems it might be pointless to use it in the experiment, though it might have value as a positive control.

Regarding your comments in 6) it is true that it is impossible to run a ‘perfect’ test as it would mean running back in time in some sort of parallel universe and having side-by-side comparisons. Given that restriction, something like what I describe should have enough data to wash out individual exceptional events as and allow a statistically reliable consensus on whether a given PED is in fact enhancing. No experiment is perfect and all experiments have margins of error. By increasing the size of the test population you can get better and better estimations of what is true, but the ‘truth’ will always elude. Such is the nature of science.

I wish we could get some input from professional cyclists regarding the boneheadedness of this idea. Clearly if WADA et. al. is going to give these guys lifetime bans getting volunteers (at least in the prime of their careers) is going to be impossible. However, if such ‘legal’ issues were to be resolved in favor of the experiment, what would they say? If we offer them, say, a 10% raise over what they expect to get for their regular jobs and can train and ‘compete’ in one spot for the duration (Colorado comes to mind) so they don’t have to travel everywhere perhaps we could lure enough takers. How many people are on a team that never compete in any meaningful events? So basically they are paid to train their asses off all year, not so different from what we would be asking of them. As for what would motivate them to train hard and compete hard, obviously some money would do it, but I suspect natural competitiveness might as well. Sports physiologists would probably enjoy the challenge of motivating these people.

Anyone out there that can speak from the perspective of the pro cyclist? My impression is there are thousands of cyclists that are able to compete with the peloton on a tour (i.e., are not dropped because of finishing too late), mightn’t there be a hundred interested in a bit more pay and a lot less travel?

eightzero September 4, 2009 at 9:36 pm

http://www.velonews.com/article/97468/damsgaard-responds-to-speculation-about-lance-armstrong-s

“Personally, I am very much in line with other experts that in the recent days (have) declared that circumstantial evidence constitute a real threat to the individual athletes “rule of law,” since athletes have no real option to disprove such accusations.”

HAHAHA! Oh, stop it. You’re killing me.

See also: trustbut.blogspot.com

Out here there be dragons.

William Schart September 5, 2009 at 10:12 am

I can’t speak with authority for professional cyclists, but it seems to me that most of them are motivated by more than just money. A large part, IMHO, of their motivation to do what they do is the, for lack of a better term, glory. At least for the top ones. Do you suppose that Lance, ALberto, etc. are motivated to win the TdF simply for the $$ they get? As I understand, most if not all the prize money is distributed to the rest of the team as reward for their help.

It is possible that at the other end of the pro spectrum you might get some takers, especially those who might be on the bubble, so to speak. “Hey, I might not get rehired next year, so I’ll take a year’s guaranteed
salary and participate in this study.” Or you might get those about to retire: a year’s paid training and racing in Colorado, for example, might be an attractive end of career move, beats traveling all over the place. But I think, even if you ironed out the “legal” situation (WADA/UDI willing to grant dispensation and allow the testees to return to competition after sufficient time for the effects to wear off), few if any cyclists would be willing to take a year out of their career.

On a different, one problem I find with any attempt to study human performance is the psychological factor. One cyclist might beat another, not because he was in better shape, or even because he was (better) doped, but because he was willing to push himself harder, to suffer more when the chips were down. I have known riders that do very well head-to-head, but not so well when on their own. You could let them attack, get a bit down the road, then chase them down relatively easily; or alternatively, if you dropped them, they wouldn’t chase you down. I often think this may be one reason why some otherwise strong cyclists do poorly in time trials: without someone on your wheel to push you, you don’t push yourself the same.

Larry September 6, 2009 at 9:00 pm

After giving this some thought, I think this study should focus on young amateur athletes. I don’t think that any athlete with dreams of a pro career would participate in such a study, but it’s possible that the test might attract reasonably talented amateurs who plan to make their livings outside of sports.

Yes, such a study would not tell us anything about the effect of PEDs on world class elite athletes, such as those who race in the world cycling tours. But IMHO, our primary focus should not be on elite athletes. Instead, my concern is for young amateur athletes who take PEDs to make their college or high school teams, or for other reasons. If PEDs work for these young athletes, that’s good enough reason (again IMHO) to ban these drugs at all levels of sport. Even the top pros start as promising amateurs, and if PEDs unfairly help amateurs become top pros, then there’s good cause to outlaw the PEDs for everyone.

William Schart September 6, 2009 at 10:21 pm

You know Larry, you may be on to something here. To date, most anti-doping efforts seem to be directed at the top levels of competition: professionals and the Olympics (where most athletes are effectively professional). But if we can raise up the younger generation to avoid using PEDs, we may ultimately be more effective. We should try to instill the idea that PEDs are to be avoided not just because they are banned and if caught we will be suspended, but that it is outside of the “code of the peleton” to use, just as Jan did not attack Lance when the spectator knocked him over some years back.

Rant September 7, 2009 at 9:00 am

Yikes! Not sure how comments got closed on this post. Sorry for the inconvenience, folks. Lots of interesting discussion going on here. When I get back home, I’ll be posting about my adventure at Stage 1 of the ToM.
Pretty wild about WADA dropping their appeal of the Hamilton decision. Not surprising they’d pull a move like that at the end of a Friday before a holiday weekend. Good way to bury the story.
The story about the Danish research making vague pronouncements about Armstrong’s blood values is interesting. I like Rasmus Damsgaard’s response. Anyone can speculate about anything, but it wasn’t a very responsible thing to do — especially given that there are a number of other explanations that are equally (or perhaps more) likely.

eightzero September 7, 2009 at 4:27 pm

Back to the proposed clinical trial – one thing you *could* do (and get an IRB to approve) would be to set up a deceptive trial. Don’t use any PEDs at all – just tell one group they are getting the latest Secret Sauce(tm) under controlled conditions, and the other placebo. See if there is a measurable difference.

William Schart September 7, 2009 at 7:37 pm

Does anyone have any idea on how WADA decides what to put on the list of banned substances? Consider for example testosterone: despite all the hoopla generated by the Landis affair, I never saw any sort of definitive statement that it is of any benefit to a cyclist. Sure, there were some vague references to “helps recovery” and the like by various people, but these were all pretty much just informal, anecdotal statements, quite possibly the result of placebo effects. Just what does “helps recovery” mean and how is this accomplished (i.e., what is the physiological effect involved)?

This is perhaps were we could get some sort of more or less scientific approach. For example, we know that EPO and its relatives increase the amount of red blood cells and hence the ability of the blood to transport oxygen; any obvious advantage for an endurance athlete, even if we are not sure of the exact amount of benefit. So these types of substances go on the banned list, no argument. But if I claim that intake of banana peel will aid performance, because I ate some and then put up a PR, then perhaps we should take a look into whether or not there is any way BP could provide a benefit.

mitakeet September 8, 2009 at 6:54 am

While I appreciate everyone’s responses, it looks like this isn’t going to generate the sorts of interest that might lead to something in the future. Perhaps the subject is still too controversial (I had hoped that there might be fallout from the Landis affair that might lead to greater scrutiny on WADA et. al., but that does not appear to be the case) and no one wants to get involved.

Eightzero I find that article most illuminating. One person’s pure (and admitted) speculation is picked up as fact to be promulgated around the world. Science fact supplanted by science fiction. A sad commentary on our credulous world.

William, your suggestion of targeting end-of-career athletes is something that I had considered, though my concern is that they are not pushing themselves to their max. Those ‘on the bubble’ were kind of my target as I was thinking about the issue initially; I don’t expect the elite of the elite athletes (Armstrong, et. al.) to be the slightest bit interested. I agree that ‘glory’ is likely a highly motivating factor at the peak (and probably substantially down from the peak) but everyone has to eat and those who might be having problems spending every day on their bikes because they need to work regular jobs to pay the bills might find a ‘job’ like this perfect as a way to try to take themselves to the next level and be hired as full-timers going forward. Elite amateurs might be a good target, particularly if they enjoy the idea of getting paid to train all year (of course, then they stop being amateurs, right? ;-), but my concern in many of these cases is that by going from a part-time training schedule to a full-time schedule separating out the effects (if any) of the PEDs from their improvement from the regular training might be difficult (but perhaps not, we would need some experts to weigh in to have a better idea). Your final comments are speaking directly toward my feelings about PEDs. If simply being on the bike a couple of extra hours a day leads to a several percent improvement in overall performance (as, I believe, many would strongly suspect) then it might be that PED usage leads to putting in those extra hours (this was brought up earlier in the comments) to repay the ‘investment’ in PEDs and not any ‘direct’ improvement in performance.

I really like the idea of the BP test as it speaks directly toward the idea that PEDs performance enhancement is from the placebo effect. However, I doubt that any number of trails that specifically exclude comparison with ‘real’ PEDs would result in any pressure for WADA et. al. to alter their criteria. As mentioned in the Landis case, there was essentially no discussion of any performance enhancement from steroids, just that he had tested positive. Of course, that throws the entire raison d’être of WADA into question if someone were to demonstrate a total lack of performance enhancement as then their only argument for existence is that they need to prove people are taking drugs that have no impact on their performance, a pretty thin argument that is not likely to continue their funding in the long run. However, if this sort of study is never done then there never will be any evidence to show that WADA has destroyed so many careers for no purpose other than administrative box checking.

I would encourage any late readers to notify anyone they think might be in a position to carry this idea forward and ask them to add their opinions.

Thanks again for everyone’s efforts!

Rant September 8, 2009 at 9:14 pm

mitakeet,
Thanks for taking the time to put together the proposal. From my perspective, there is much to be learned by running an experiment aimed at determining the true effectiveness of the various purported doping methods. There has been one study I know of that approaches what you’ve suggested, and it was done in 1958 or 1959, aimed at determining the performance-enhancing benefits of amphetamines. Bottom line was that an effect was found, and the benefits varied from one sport to another. Perhaps there have been others that are somewhat akin to what you have in mind. If we’re going to ban various drugs/methods, we ought to know whether they have any real impact. Otherwise, we may be spending valuable resources chasing down “cheaters” who are mostly being cheated out of the money they’re spending on their “doping” programs.
One way to make sure that the resources spent on the fight against doping are being spent effectively is to know what works, what doesn’t and concentrate on catching those who are using the methods that do have a positive impact on performance. To do so, some sort of scientific study needs to be done.
I suspect that there may be a few more comments trickling in over time, as this was posted and discussed over Labor Day weekend. Some regulars may have been away from a steady Internet connection over the last few days while on holiday (myself, included, as it turns out). Some of those regulars may weigh in over the coming days. We’ll see, anyway.

Jeff September 9, 2009 at 8:23 am

Rant wrote:
“One way to make sure that the resources spent on the fight against doping are being spent effectively is to know what works, what doesn’t and concentrate on catching those who are using the methods that do have a positive impact on performance. To do so, some sort of scientific study needs to be done.”

The sentiment in your statement may be obvious to some, but seems quite lost on WADA and many of their more vocal supporters. There is the old notion that if you say something often enough, it will begin to sound true, regardless of the pronouncement actually being true or false. This seems to be a good portion of what WADA practices with its banned substance and practices list. I find it hard to fathom how an organization that purportedly relies on science to carry out its mission is so inclined to play fast and loose with basic science. But then again, with bureaucracies such as WADA, Job #1 is to sustain the bureaucracy. Job #2 is that insignificant factors, such as truth and science, should not be allowed to interfere with Job #1.

I’ll add that studies of banned products and practices (which won’t happen), should also verify the product/practice is 1) detrimental to the health of the athlete, or 2) creates an undue burden (and unfair disadvantage) for competing athletes due to cost or availability. Only then should they be banned. (for all we know at this point, many of the items on the banned list either promote good health or honest competition) Social engineering should not be a factor. (Don’t even get me started on THC and knuckle dragging snowboarders)

Jean C September 11, 2009 at 7:24 am

Jeff,

Here http://rant-your-head-off.com/WordPress/?p=2316, you write as response :

HCT is a very rough measurement in this (and most other) case(s). The variables were not controlled, therefore using the measurements, as a link toward indicating doping is not fit for purpose. The variables include hydration levels of the subject, instrument calibration, ……

That seems a bit sketchy when we know that for years most of riders were just under the 50% limits! How could that be possible if the measurement were not accurate? A lot of athletes should have been not allowed to race.

Hydration affects hct level but not hemoglobin or reticulocytes! Lance posted his values and it’s not only hct that is suspicious the other measurements are strange too : http://www.cyclingnews.com/features/analysis-armstrongs-tour-blood-levels-debated

But my original question was “Why Lance didn’t get his magic 49 hct level that year ? Why he repeated that it was easy to have a 49 hct by just sleeping in an altitude or by training at atltitude?”
We all know now that a high hct level is a big advantage “Why don’t use that kind of technics as by the past?”

The only explanation is that he lied: altitude tent or training high will never give a bonus of 6 or 7 hct points, besides a lot of research studies gives a 2or 3 points benefit.
So how Lance got his 49 hct by the past? Surely by doping. That is another point giving more credits to all other doping stories of Lance Armstrong (EPO samples of 1999, US Postal doping rubbish, Ferrari, Simeoni, Bassons, …)

Jeff September 11, 2009 at 10:00 am

Jean C,

You are expanding the argument past the content of my post. I wrote that LA might have doped, or might not have. I’m not defending either position. The HCT reports from the tour cannot prove that one way or the other. I’m being critical of numbers being posted that are not fit for comparison.Simply put, there is zero assurance we are comparing apples to apples with the numbers assigned to the values. Without assurance the common variables were controlled so that we have an apples to apples scenario, then we can’t rely on the numbers for comparative purposes. Or more simply, garbage in and garbage out……

BannaOj September 30, 2009 at 8:38 am

Catching up…

You know who will run these studies (and possibly already has?) The military. Of course, getting them to admit it is a little harder, because of the ethical concerns involved. But they’ve got a pretty good idea of what kind of drugs improve performance for both your standard soldier and your Special forces type.

Stuff from the Vietnam Era may or may not be declassified yet, but if that data could be obtained I think it would tell us a lot about how to possibly do future tests.

Rant October 3, 2009 at 8:11 am

My turn to catch up now, BannaOj.
That’s a great idea. The military are definitely interested in all sorts of forms of performance enhancement, especially those that will give a benefit during combat. I agree that if the data could be obtained, it would be quite instructive and shed some light on the direction for future research.

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