The Mexico City Olympics held in 1968 were the first to introduce drug testing for medallists, with urine taken and analyzed for narcotics and stimulants. Consequently, these Games saw the first ever drugs disqualification, with the Swedish pentathlete Hans-Gunnar Liljenwall testing positive for excessive alcohol. He had allegedly drunk some beer prior to the pistol shooting to calm his nerves and was later stripped of the bronze medal he went on to win.
The August 7, 2008 issue of Nature has an article by a biostatistician and an accompanying editorial criticizing task the logical and scientific assumptions behind anti-doping tests commonly used in sports.
Donald Berry’s article, The Science of Doping, is interesting because it looks at the methods used to take away the Tour de France championship of Floyd Landis, who continues to maintain that he did not use performance enhancing drugs. According to Berry,
Landis seemed to have an unusual test result. Because he was among the leaders he provided 8 pairs of urine samples (of the total of approximately 126 sample-pairs in the 2006 Tour de France). So there were 8 opportunities for a true positive — and 8 opportunities for a false positive. If he never doped and assuming a specificity of 95%, the probability of all 8 samples being labelled ‘negative’ is the eighth power of 0.95, or 0.66. Therefore, Landis’s false-positive rate for the race as a whole would be about 34%. Even a very high specificity of 99% would mean a false-positive rate of about 8%. The single-test specificity would have to be increased to much greater than 99% to have an acceptable false-positive rate. But we don’t know the single-test specificity because the appropriate studies have not been performed or published.
More important than the number of samples from one individual is the total number of samples tested. With 126 samples, assuming 99% specificity, the false-positive rate is 72%. So, an apparently unusual test result may not be unusual at all when viewed from the perspective of multiple tests. This is well understood by statisticians, who routinely adjust for multiple testing. I believe that test results much more unusual than the 99th percentile among non-dopers should be required before they can be labelled ‘positive’.
Berry also claims that the proper vetting of the tests used on cyclists have never been done (emphasis added),
The method used to establish the criterion for discriminating one group from another has not been published, and tests have not been performed to establish sensitivity and specificity. Without further validation in independent experiments, testing is subject to extreme biases. The LNDD lab disagrees with my interpretation. But if conventional doping testing were to be submitted to a regulatory agency such as the US Food and Drug Administration5 to qualify as a diagnostic test for a disease, it would be rejected.
The Nature editorial really drives this point home. It notes that tests for banned substances are developed essentially by having a small number of control subjects ingest the substance and then using analyses of blood and urine from those individuals to set acceptable limits of substances and their byproducts.
But not only are these small groups, but the threshold levels are never made public,
Nature believes that accepting ‘legal limits’ of specific metabolites without such rigorous verification goes against the foundational standards of modern science, and results in an arbitrary test for which the rate of false positives and false negatives can never be known. By leaving these rates unknown, and by not publishing and opening to broader scientific scrutiny the methods by which testing labs engage in study, it is Nature‘s view that the anti-doping authorities have fostered a sporting culture of suspicion, secrecy and fear.
Detecting cheats is meant to promote fairness, but drug testing should not be exempt from the scientific principles and standards that apply to other biomedical sciences, such as disease diagnostics. The alternative could see the innocent being punished while the guilty escape on the grounds of reasonable doubt.
It’s the sports world’s version of security through obscurity.
On the other hand, the idea that using performance enhancing drugs is “cheating” is itself a major part of the problem. The Economist had a reasonable article about performance enhancing drugs a couple weeks ago which made the case for bannings substances based strictly on safety not supposed performance enhancing properties. If a drug, when used properly, is completely safe there is no more reason to ban it than there would be to ban athletes from engaging in weight training, special diets, training at different altitudes, or any number of other performance enhancing techniques that athletes routinely engage in.
End the witch hunts — allow the drugs.
U.S. News and World Report’s Alex Kingsbury does a nice job discussing another profession where the use of performance enhancing drug is believed to be widespread — classical musicians. According to Kingsbury, a significant percentage of musicians — as well as actrs and other performers — turn to beta blockers to lower their blood pressure and thereby presumably improve their performance.
Use of Ritalin and other ADHD drugs is allegedly common on college campuses, and personally I don’t start my day without a 32 ounce helping of my favorite caffeine-laced performance enhancing diet cola.
It is a shame that Kingsbury can’t take the obvious next step as to whether those of us who use our own performance enhancing drugs should really be judging athletes who use drugs more appropriate to their profession. Instead he dredges up bioethicist Greg Kaebnick who offers this pearl of wisdom,
There’s no general ethical principle for enhancement — a performance that one group celebrates as a manifestation of natural talent and practice boosted by a drug, another group sees as cheating.
Ah, the ad hocracy that is contemporary bioethics. Forget any attempt at logical consistency or, god forbid, something as quaint as a general ethical principle.
A few weeks ago, Bob Costas moderated a debate on the proposition that, “We should accept performance-enhancing drugs in competitive sports.” NPR has the completed, unedited debate in streaming media format on this page, or you can download a PDF transcript of the debate (PDF).
On the Reason magazine blog, debate participant Radley Balko describes a bit of the debate from his point of view, noting that at least when it comes to safety issues, performance enhancing drugs like steroids are far safer than other things that top tier athletes are regularly required to do to their bodies in order to meet the requirements of their particular sport,
[Sportscaster George] Michael also took offense to a comparison I made between the relatively modest risks of steroids and HGH and the other health risks other athletes take to excel. The example I used was horseracing, where the athletes subject themselves to sweat boxes, diuretics, eating disorders, and all sorts of other damaging weight-control techniques. Michael, a horse breeder, was offended that I’d make such accusationsâ€”until he realized I was talking about the jockeys, not the horses. Oddly, that didn’t seem to bother him as much.
Dr. Norman Frost put that argument more explicitly in the debate, which NPR features in a pull quote on its page,
I ask you in the audience to quickly name, in your own minds, a single elite athlete who’s had a stroke or a heart attack while playing sports. It’s hard to come up with one. Anabolic steroids do have undesirable side effects: acne, baldness, voice changes … infertility. But sport itself is far more dangerous, and we don’t prohibit it. The number of deaths from playing professional football and college football are 50 to 100 times higher than even the wild exaggerations about steroids. More people have died playing baseball than have died of steroid use.
In general, the argument against allowing performance enhancing drugs in sports tend to lack any coherence. Rather, people who complain about performance enhancing drugs seem to have the same sort of visceral reaction as people of a different era had when anesthesia became widely used to alleviate pain during childbirth — it just violates widely held moral intuitions that amount to one society-wide “ick” at the thought of athletes explicitly modifying their body chemistry with drugs in order to achieve better performance.
It just seems wrong, even if the arguments against it aren’t all that logically consistent.
Aside from all the hype over genuinely performance enhancing drugs, one of the silliest performance enhancement stories revolves around the color of uniforms.
The May 19, 2005 issue of Nature published a study by Russell Hill and Robert Barton that examined whether or not the color of uniforms affected sports performance (I’m not making this up).
They examined a number of Olympic sporting where contestants were randomly assigned blue or red uniforms and found that the red-clothed athletes outperformed the blue-clad ones. “We find that wearing red is consistently associated with higher probability of winning,” Hill and Barton said.
That’s true enough, but given the relatively small sample of boxing, tae kwon do, Greco-Roman wrestling and freestyle wrestling events, not much else seems warranted. An obvious point about these events is that they specifically require interpersonal violence. Even if there is some specific bias toward players donned in red in such sports, it doesn’t follow that this holds in other competitions.
And concluding, as the researchers do, that “The color of sportswear needs to be taken into account to ensure a level playing field in sport” seems wholly unwarranted by their small sample.
In fact, it is awfully similar to the nonsense stats that sports commentators throw around. My favorite are the teams that supposedly are handicapped by either cold or hot weather typically based on ridiculously small sample sizes (usually less than 12 such games).
Red outfits give athletes advantage. Rob Roy Britt, LiveScience, May 18, 2005.
In Sports, Red Is Winning Color, Study Says. John Roach, National Geographic News, May 18, 2005.
As I’ve said before, I really don’t understand what the big deal over performance enhancing drugs in sports is. The Associated Press recently reported on a series of performance enhancing contact lenses being produced by Nike and Bausch&Lomb that illustrates the fuzzy thinking surrounding anything that conveys a benefit in athletic competition.
According to the Associated Press,
The lens — large enough to extend a ring around the iris — comes in two colors: amber and grey-green.
The amber lens is for fast-moving balls sports, such as tennis, baseball, football or soccer. Grey-green is better for blocking glare for runners or helping a golfer read the contour of the ground.
This, of course, immediately brings a reaction that — assuming the lenses actually live up to Nike’s hype — it might be unfair if some people use these sorts of lenses while others don’t,
Jerry Diehl, assistant director of the National Federation of State High School Associations in Indianapolis, said his group doesn’t believe the lenses provide the competitive advantage that Nike claims.
The federation allows the lenses and puts them in the same category as sunglasses or corrective lenses. The NCAA also allows the sports lenses because it considers them similar to sunglasses.
But Diehl said he’s worried about the perception of an unfair advantage.
‘If one affluent team can get this, it forces everybody else to go out and do that,’ Diehl said. ‘Is it really something that makes a difference? In this instance, at this juncture anyway, it doesn’t seem to be any better or any worse than allowing what is already under the rule.’
But affluent teams and athletes already have a myriad of advantages. They have access, in general, to better training facilities, better training programs, better coaching, and so on.
And, of course, it is no more “fair” (whatever that means) that Ted Williams supposedly had 20/10 vision than that someone may potentially use specially tinted lenses — or performance enhancing drugs such as steroids.
Life ain’t fair and neither are athletic competitions.
New contact lenses give athletes an edge. Associated Press, June 4, 2006.