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The dog ate my homework: Uncertainty and anti-doping tests

Editor’s note: This is an excerpt from an article that VeloNews contributor Steve Maxwell and his partner Joe Harris recently published on TheOuterLine.com. In it, Dr. William Apollo, a cardiologist and former bike racer from Harrisburg, Pennsylvania, explores some of the vexing questions and challenges surrounding the uncertainty that comes with some types of anti-doping tests.

Positive doping tests or “adverse analytical findings” in professional cycling can be highly uncertain and controversial, and can lead to months or years of costly wrangling and disputes, both in the legal system and in the court of public opinion — often without any satisfactory or consensus outcome. While the sport has upped its effort to discover and expose drug cheats, many observers believe that some racers are still getting away with the use of various undetected performance-enhancing drugs. What often attracts less attention is the case where it appears that clean riders are being unfairly accused. It is important to realize that while rapidly advancing analytical technology has unquestionably improved the precision and accuracy of drug testing, it’s not perfect; there will always be some inherent error in the process. And this means that we may occasionally punish the wrong person. In addition, the ability of modern analytical instruments to detect vanishingly low levels of compounds raises the more fundamental and practical question of relevant threshold levels — at what level should we even be concerned about the presence or absence of a certain chemical?

Professional bicycle racing is a beautiful sport. Every July, both fans and cyclists are transfixed by the French countryside, watching the colorful, rolling pageant of the Tour de France. Over three weeks, an epic drama, complete with mountains, sunflowers, and castles, is played out on miles of black winding ribbons. Each day’s episode unfolds with panache and romanticism until the peloton reaches the Champs-Élysées.

But in recent years, this idealized image of professional cycling has been tarnished due to persistent doping scandals. Quixotic results are now viewed with skepticism and are heavily scrutinized by fans and the media alike. Refreshingly, in September 2014, the Cycling Anti-Doping Foundation (CADF) issued a press release indicating that there were no positive doping tests identified at the 2014 Tour de France. There was a collective sigh of relief from the cycling community. According to the UCI, “all the samples collected were systematically analyzed to detect stimulants and erythropoiesis.” Additionally, “isotope ratio mass spectrometry (IRMS) was also analyzed in a certain number of samples, in particular to detect testosterone abuse and its precursors.” Brian Cookson, President of the UCI, acknowledged the success of anti-doping efforts at this year’s Tour de France and cited collaboration among the World Anti-Doping Agency (WADA), CADF, UK Anti-Doping, and French Anti-Doping organizations as the key to this success.

The specific and deliberate wording of the UCI statement indicates that, despite effective collaboration among governing bodies, technological advances cannot be ignored when discussing anti-doping efforts. It must be understood, however, that the science of anti-doping controls is not exact. No laboratory test is completely perfect; any testing procedure is associated with some inherent degree of error. But at the same time, the results of these doping controls have the power to change lives, careers and the history of sport itself. It is therefore important to understand potential sources of inconsistency involved with laboratory testing, as well as reporting of results, to determine whether sanctions against an athlete are fair and reasonable. In some cases, the inherent inconsistencies of testing could potentially be used by an athlete to gain an unfair advantage. On the other hand, inherent errors involved in laboratory testing could implicate an entirely innocent athlete in a doping scandal.

It seems that adverse analytical findings are rarely followed by athlete confessions. In fact, alleged doping violations are typically followed by long arduous proceedings in an attempt to determine an athlete’s guilt or innocence. Many times, athletes categorically deny any knowledge of doping activity and blame the abnormal test value on a whole range of circumstances beyond their control. Contaminated foods or supplements, mislabeled products, pharmacy mistakes, and disappearing twins in utero are only some of the more “creative” excuses. Cycling fans have become weary of this by now predictable sequence of events and have begun to view these excuses as another case of “the dog ate my homework.” But what if the dog actually did eat your homework? Would anyone believe you? This article, by focusing on two common anti-doping measurements, will illustrate some of the analytical and procedural complexities involved in the effort to ensure clean and fair sport.

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