The science of doping - positive means nothing, negative means nothing. So what to do?
Last week saw some interesting debate around doping and sports achievers, inspired by Jonathan's post on the start of cycling's first Grand Tour of the year, the Giro d'Italia. The shift to the Grand Tours usually serves as the catalyst for doping discussions - sadly, few races will go by without a big doping story. Even before the Giro began, doping hit the news. And I suspect that the next few months may well stimulate further doping debates on this site, as well as others that cover the sport of cycling.
In response to that article, we got some pretty interesting comments and opinions from readers, and those have been fermenting in my mind for the last few days, inspiring this post. Then, this morning, I came across a journal with some discussion around the "science of doping" and it seemed a good marriage between the discussions.
The problem with performance: Is doping non-negotiable?
To begin with, the post last week discussed the recent positive tests of Rashid Ramzi and Davide Rebellin, and mentioned that the environment we find ourselves in compels us to question pretty much every athletic performance. A winner in sport (particularly cycling and athletics) not only receives medals and prize money, but now also inherits a mantle of suspicion thanks to what is a growing history of doped up champions. So, we watch the men's 100m final and see an incredibly dominant victory by Usain Bolt. Sadly, we are almost compelled to ASK (not judge, take note) whether the performance is believable? Yesterday, watching the first mountian-top finish of the Giro, I felt myself asking the same question of just about every cyclist attacking off the front.
Because we've been shown by case after case that success is often achieved thanks to doping (remember for example that 4 out of the last 6 100m champions have tested positive, and every winner of the Tour de France since 1996 has either confessed, been implicated through investigative work, or tested positive despite some denials), we tend to lapse into a "guilty" verdict all the time.
In response to this post, we received the following comments - I've taken the relative bits out of two of them, but you can read the originals here:
I agree with Cassio. Bolt is obviously doped.
If he can do a lot better than previous doped runners, he is doped too. Of course he is very talented, and his junior results show just that. But I see that as an explanation of his amazing results, if he wasn´t talented, with or without doping, he would never be able to get those far superior times.
I'm sure of two things: Bolt is an amazing athlete and person, very talented guy and makes people happy. Second: Bolt is very, very doped, if it is possible to be more than just doped...
I concur, Anonymous. I'm always amazed that our sports scientists (seem to?) think that many champions & gold medalists are completely clean. Is this attitude wide-spread among your colleagues or are you the only optimists hoping that people can break world-records without doping?
Personally, I've heard sport MDs (e.g. Moosburger) claim - quite to the contrary - that it is unlikely that any records have been broken without doping in the last 40 or 50 years. That's pretty much the same I keep hearing from different people practising competetive sports & doping themselves.
Both comments are fairly (very) cynical. As a scientist, I applaud your cynicism! These viewpoints represent the far extreme of opinion on a spectrum that extends all the way from "believer" to "complete cynic". So there are people who believe the all winners and sportsmen are clean. I once received an email saying that professional sportspeople love their bodies and respect their health and so they would never dope! On the other extreme is this view, which pretty much states that success REQUIRES doping, and therefore the only requirement to catch a dope cheat is to observe who wins!
Neight extreme is particularly "selective" in how it approaches the problem, and I think most people will appreciate that this is unlikely to produce a very fair or accurate assessment. Either you believe that no-one dopes and wins, or that everyone must dope to win. The first case of an athlete who does not fit the model disproves it and so not many would have such a dogmatic view.
Flags and pointers
Instead, most would (we hope) recognize that it's unlikely to be that clear-cut either way. Our approach, speaking now as the above mentioned sports scientists who are involved in sport from both a scientific and sports-coaching perspective (and marketing, in my case) would be to evaluate every case on the collection of evidence for it, thought this is obviously very difficult to do. Too much misinformation, too much deception, denials in the face of strong evidence, and evidence that is often questionable all complicate matters.
One of the most telling (or suspicious) factors is a sudden improvement in the performance. People were suspicious of Rashid Ramzi for this reason - nowhere one year, double world champ the next. Erratic performances outside of major championships are another - again, Ramzi is a case in point - between the odd world championship gold he did little or nothing in major meetings.
The trouble with both arguments is that they exclude athletes who either develop later (admittedly, a small group), or because those major performances could just as easily be attributed to a "periodized training programme" and a focus on only a few races. That's one we've heard a lot in cycling and the Tour de France in recent years. So it's easy to say "I told you so" in the case of Ramzi, because people's suspicions seem to have been confirmed. But they may well be incorrect in other cases.
Even evaluating a historical progression of performance poses problems. In the aftermath of Usain Bolt's remarkable Beijing performances, we looked at his times as a junior when he displayed remarkable talent from a young age when drugs were almost certainly not a factor. Problem is, some people looked at the same performances and said he IS doping, we said it suggested he wasn't! So the same numbers produce two different conclusions!
Similarly, many of the top east Africans emerge as teenagers running times that clearly set them apart as world-class, and with training and maturity, their normal progression could be to the status of world record holder. Here, the problem is that we are never 100% sure that their ages are reported accurately, and we just don't know where the ceiling exists - projecting times forward is very difficult to do. And so performance reviews are fraught with difficulty.
Doping control - proof of innocence and guilt?
And this brings us onto doping control, where it gets really interesting! In an ideal world, athletes would be tested, and the results from the infallible laboratory and willing athletes would tell us that an athlete can be believed as clean or disqualified as a dope cheat. Unfortunately, that is a dream that belongs in the past.
Doping control became so flawed in recent times as the testers fell behind the cheats that drugs were being used with zero chance of being detected. Methods to avoid detection, drugs that were undetectable, and conspiracies and collusion to cover up positive tests mean that the ideal is far removed from the reality. The world was made aware of this when a designer steroid called THG was discovered only because an anonymous tip-off from a coach sent a syringe to doping authorities. Without personal rivalrly and jealousy leading to this tip-off, there is no telling whether we might still be celebrating the performances of Marion Jones, Dwain Chambers and Tim Montgomery.
I have heard quotes from some experts to the effect that for every banned substance we CAN test for, there is another we can't. Others say, perhaps with some hyperbole, that there are 100 undetectable products! Last year, the Tour de France threw up a test for CERA, a newly designed third-generation EPO, which was supposed to be undetectable, but for the collaboration between WADA and the pharmaceutical company that made it. The question is - how many CERAs exist where collaboration has NOT discovered the test?
Marion Jones would be a multiple gold-medallist, one of the greatest athletes in history and perfectly clean in the eyes of those who advocate that "when you pass a drug test, it means you are innocent". To this day, Jones has never failed a drug test - it was only the "manhunt" that ensued when the BALCO affair began that exposed her.
Similarly, cyclists who claim to be clean and point to their record of being tested often are proving nothing. Being the most tested athlete or sport in the world does not mean the same thing as being a dope-free athlete. So sadly, we can't believe the negative tests.
Positive tests - do they mean anything?
Even more sadly, according to some experts in recent times, we can't believe the positive tests either! In 2008, a paper in the prestigious journal Nature called into view what was called the "fallacy" of the current doping testing practices. The paper, written by a bio-statistician, asked the question "When an athlete tests positive, is he or she guilty of doping?" He went on to answer his own question with the following: "Because of what I believe to be inherent flaws in the testing practices of doping laboratories, the answer, quite possibly, is no."
The article, which you can access with a subscription (or feel free to email us if you'd fancy a copy), was the catalyst for a whole series of comments and debates around the general principle of doping control. Papers have been published (and criticized) calling WADA to task for their ability to accurately test for drug use. Court cases are usually the result of these flaws, because any athlete worth his weight in legal fees recognizes that when a possible weakness in testing exists, it must be legally challenged. Why confess when you can get off on a technicality?
Unfortunately, technicalities do happen, and that makes enforcing doping control very difficult, if not impossible. People have called for life-time bans for drug cheats - this is impossible unless the system to catch dopers is 100% accurate. It isn't, though I'd like to think it is improving (based on what I have heard from colleagues).
The reality is that testing neither proves nor disproves doping. It provides a guide, certainly, and perhaps the introduction of the blood passport system will see the status quo change. I'm sceptical myself, mostly because everything is still so clandestine.
Wikinomics, jury duty and all available evidence
Regular readers will recall that I advocated what I called "Wiki" doping control a while back, based on a book called Wikinomics, which itself is a symptom of the latest trends in how the world operates. The days of narrow hierarchies and chains-of-command have been replaced by open-source, collaborative efforts. Without rehashing the book and business principles, I believe doping control should consider means to spread the knowledge in order to become more responsive to the problem, and this means secrecy is not an option.. Sadly, it's very secretive, and may well find itself falling further and further behind the modern "organization" that drives doping.
In any event, where does this leave us? When we assess performances, like those of the Giro winner (whoever that may be) or Usain Bolt, we have to make the best possible call based on ALL the evidence. I think we are headed for an era where doping sanctions are handled like legal court-cases, and the admissable evidence is not limited to a doping test.
Rather, they will be run like a criminal trial where all the evidence is weighed up and a verdict delivered. Where this kind of process would leave those athletes who remain in the "dock", I don't know. If I were on the jury, I certainly know what verdict i'd be reaching!
There are no answers to these questions. What I do know is that there are elite athletes who succeed without doping, and there are plenty of successful athletes who are doping without getting caught. The doubt is pervasive, and sadly everyone is tainted by it. Your thoughts are, as always, welcome, and if you have any suggestions, feel free to give them.
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Wednesday, May 13, 2009
The science of doping - positive means nothing, negative means nothing. So what to do?