All About Salbutamol

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What will the verdict in Froome's salbutamol case?

  • He will be cleared

    Votes: 43 34.1%
  • 3 month ban

    Votes: 4 3.2%
  • 6 month ban

    Votes: 15 11.9%
  • 9 month ban

    Votes: 24 19.0%
  • 1 year ban

    Votes: 16 12.7%
  • 2 year ban

    Votes: 21 16.7%
  • 4 year ban

    Votes: 3 2.4%

  • Total voters
    126
Aug 12, 2009
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thehog said:
Merckx index said:
gillan1969 said:
in the interests of transparency we await publication of the defence............then we will have the information

They brought on this speculation by publishing the decision before publishing the details--though I suppose they did that to forestall the decision on whether Froome would be allowed to ride. Still, it was a dumb thing to do.

Appears ASO forced that situation with their announcement on Sunday. WADA acted fast and the UCI had no choice but to follow. Then WADA pretended it was the UCIs decision.

At this point there can be no salbutamol limit any longer for any athlete. Truely bizarre set of circumstances.

it does seem bizarre and we should presumably have the UCI chaperone's testimony that he took the 'press conference' puffs?

presumably you could (even without a doc) argue that no study could replicate that exactly GT you were riding.....

yup...that's that test out the window (unless you are an idiot master :) )
 
Jul 27, 2010
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Here’s a little more from VN:

WADA said a few factors contributed to its decision not to pursue an appeal. It said, “a significant increase in dose, over a short period prior to the doping control, in connection with a documented illness; as well as, demonstrated within-subject variability in the excretion of Salbutamol,” indicate that Froome was taking the drug via inhaler, as is permitted by the rules.

So it’s basically the Heuberger paper, plus illness. It’s not clear to me whether the illness is supposed to have contributed to the variability, or only that it required Froome to take the full amount, and that they believe he never did this before. It sounds like the latter. But illness aside, this statement indicates it was the Heuberger study that swayed them, which is very fishy. WADA (or was it UCI?) said after the study came out that they had been through these arguments before, and that they were well prepared to refute them. Now they accept them, won’t even appeal.

Again, have to wait for details, but I have to say, this really smells. The main reason I have for doubting that this is a fix is because, based on what’s come out so far, it’s so blatantly obvious. I would have expected some subtlety. One thing I'm virtually certain of is that there will be a lot of pushback from pharmacologists. A lot of them are going to be very skeptical that Froome could have had this level one time and nothing close to it at any other time. I will be extremely surprised if the details are published and most of the scientific community accepts them. I don't see the controversy dying down.

I wouldn't be surprised if in a few days there is an announcement that they aren't quite ready to publish the details, but that they will be made available after the Tour.
 
Aug 12, 2009
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Re:

Merckx index said:
Here’s a little more from VN:

WADA said a few factors contributed to its decision not to pursue an appeal. It said, “a significant increase in dose, over a short period prior to the doping control, in connection with a documented illness; as well as, demonstrated within-subject variability in the excretion of Salbutamol,” indicate that Froome was taking the drug via inhaler, as is permitted by the rules.

So it’s basically the Heuberger paper, plus illness. It’s not clear to me whether the illness is supposed to have contributed to the variability, or only that it required Froome to take the full amount, and that they believe he never did this before. It sounds like the latter. But illness aside, this statement indicates it was the Heuberger study that swayed them, which is very fishy. WADA (or was it UCI?) said after the study came out that they had been through these arguments before, and that they were well prepared to refute them. Now they accept them, won’t even appeal."

Again, have to wait for details, but I have to say, this really smells. The main reason I have for doubting that this is a fix is because, based on what’s come out so far, it’s so blatantly obvious. I would have expected some subtlety.

WADA also state the "chronic use of Salbutamol at varying doses over the course of weeks of high intensity competition" This would suggest large doses on more than one occasion and yet nothing above 600? Or is this the kidney illness angle....

mental
 
Jul 11, 2013
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The cited illness (it's implications) will be kept on lid i presume?

Part of the privacy sphere?

In any case, I think we can expect loads of mud.
Little clarity...
 
Jul 9, 2012
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mrhender said:
The cited illness (it's implications) will be kept on lid i presume?

Part of the privacy sphere?

In any case, I think we can expect loads of mud.
Little clarity...

Why should you expect any ? It should have been confidential in any case.
 
Jul 5, 2009
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Merckx index said:
Here’s a little more from VN:

WADA said a few factors contributed to its decision not to pursue an appeal. It said, “a significant increase in dose, over a short period prior to the doping control, in connection with a documented illness; as well as, demonstrated within-subject variability in the excretion of Salbutamol,” indicate that Froome was taking the drug via inhaler, as is permitted by the rules.

So it’s basically the Heuberger paper, plus illness. It’s not clear to me whether the illness is supposed to have contributed to the variability, or only that it required Froome to take the full amount, and that they believe he never did this before. It sounds like the latter. But illness aside, this statement indicates it was the Heuberger study that swayed them, which is very fishy. WADA (or was it UCI?) said after the study came out that they had been through these arguments before, and that they were well prepared to refute them. Now they accept them, won’t even appeal.

Again, have to wait for details, but I have to say, this really smells. The main reason I have for doubting that this is a fix is because, based on what’s come out so far, it’s so blatantly obvious. I would have expected some subtlety. One thing I'm virtually certain of is that there will be a lot of pushback from pharmacologists. A lot of them are going to be very skeptical that Froome could have had this level one time and nothing close to it at any other time. I will be extremely surprised if the details are published and most of the scientific community accepts them. I don't see the controversy dying down.

I wouldn't be surprised if in a few days there is an announcement that they aren't quite ready to publish the details, but that they will be made available after the Tour.
It really is amazing, isn't it? But I bet the controversy does die down because soon it will be the Tour and we'll be on our way to the next scandal and outrage.

John Swannson
 
Jul 16, 2011
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Well that and the lack of benefit conferred to otherwise healthy riders. I suspect that the thyroid meds that are just as easy to abuse confer more.
 
Sep 14, 2009
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Alex Simmons/RST said:
Salbutamol isn't suddenly an option for everyone, just those with money and legal resources. What a farce.
Not sure if you are being serious or sarcastic?
 
Mar 3, 2013
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Alex Simmons/RST said:
Salbutamol isn't suddenly an option for everyone, just those with money and legal resources. What a farce.

My take on this is that now they won't be able to enforce the Salbutamol regulation against anyone until they have redrafted it with the benefit of the lessons of the Froome case. There seems to be an intention to attend to it. We don't know how that will turn out, of course.
 
May 26, 2010
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ScienceIsCool said:
Merckx index said:
Here’s a little more from VN:

WADA said a few factors contributed to its decision not to pursue an appeal. It said, “a significant increase in dose, over a short period prior to the doping control, in connection with a documented illness; as well as, demonstrated within-subject variability in the excretion of Salbutamol,” indicate that Froome was taking the drug via inhaler, as is permitted by the rules.

So it’s basically the Heuberger paper, plus illness. It’s not clear to me whether the illness is supposed to have contributed to the variability, or only that it required Froome to take the full amount, and that they believe he never did this before. It sounds like the latter. But illness aside, this statement indicates it was the Heuberger study that swayed them, which is very fishy. WADA (or was it UCI?) said after the study came out that they had been through these arguments before, and that they were well prepared to refute them. Now they accept them, won’t even appeal.

Again, have to wait for details, but I have to say, this really smells. The main reason I have for doubting that this is a fix is because, based on what’s come out so far, it’s so blatantly obvious. I would have expected some subtlety. One thing I'm virtually certain of is that there will be a lot of pushback from pharmacologists. A lot of them are going to be very skeptical that Froome could have had this level one time and nothing close to it at any other time. I will be extremely surprised if the details are published and most of the scientific community accepts them. I don't see the controversy dying down.

I wouldn't be surprised if in a few days there is an announcement that they aren't quite ready to publish the details, but that they will be made available after the Tour.
It really is amazing, isn't it? But I bet the controversy does die down because soon it will be the Tour and we'll be on our way to the next scandal and outrage.

John Swannson

Yes, I wonder who will be thrown under the bus to take the doping talk away from Sky. Watch out Astana!
 
Jul 27, 2010
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Pending release of details, here’s my best guess of how Froome’s defense went.

It begins with the Heuberger model. As I’ve pointed out earlier, WADA’s mention of samples given shortly after inhalation is pretty much a dead giveaway. No other authors I’m aware of have emphasized so much the importance of measuring samples within an hour of taking salbutamol. WADA further mentions the variability among samples, which is the whole point of Heuberger’s model: that there can be enormous variation in urine levels within the same subject following inhalation of the same amount.

Heuberger’s conclusions, as I’ve discussed several times before, simply aren’t supported by the available studies. They claim they are, but they point to only one study, and that was not using the one hour window that is critical to Froome’s case. There are in fact multiple studies that measured levels one hour after inhalation, and none of a total of several dozen samples reached the 1000 ng/ml level that, according to Heuberger et al, should occur about 15% of the time. I've discussed this in detail upthread.

That ought to be a serious criticism of the model, and a warning flag about using it to support Froome’s case. But even if the model were better supported by empirical data, Froome would want to show that his own physiology conforms to the model. To do this, he would use his Vuelta samples, of which there should have been nineteen, or eighteen other than that from stage 18. It was reported that none of these samples exceeded 600 ng/ml, but that doesn’t mean much unless we know how much salbutamol he inhaled during those other stages.

To simplify, initially, let’s assume he took only 200-300 ug in each of these stages. He claimed he took more on stage 18 because of severe symptoms, and I’m pretty sure his argument is that the levels were much lower on the other stages because he didn’t suffer from those symptoms and so didn’t take as much. To simplify further, we will assume he inhaled those 2-3 puffs near the end of each stage, and didn’t urinate between then and when he gave the sample.

He would thus have a pool of eighteen samples, all of them conforming to the Heuberger model. What he would want to show is that there was great variability in the urine levels. If the maximum was 600 ng/ml., and the minimum was, say, 100 ng/ml., he would argue that there was at least a four-fold variation (600 from three puffs vs. 100 from 2 puffs). Moreover, if he could reach 600 ng/ml with just three puffs, then clearly he might reach 1600 ng/ml with the allowed eight puffs, if we assume rough linearity. This is not far from the actual value of 2000, and actually more than the corrected value of about 1430.

I think this may be the gist of Froome’s argument. Where it gets really complicated is when one no longer simplifies. Did he really take only 2-3 puffs on all the other stages? Or maybe more on some, less on others? Does he have records of this, and can they be accepted as evidence? Can he prove he always inhaled near the end of the stage? Did he never urinate between inhalation and giving the sample (a key assumption of the Heuberger model)?

Remember, he was tested after every stage beginning with stage 3, many of which were flat or hilly runs that didn’t require a solo effort. He might not have inhaled at all on those stages, so he couldn’t use those samples at all in his argument. Even when he did inhale, he might have done so earlier in the stage or even before the stage began. And since he’s arguing he inhaled more on stage 18, because of severe symptoms, he probably inhaled more on stages right before or after that, too.

So Froome is trying to fit his data to Heuberger’s model, but the data themselves—as one would expect on the road—don’t occur under standard, controlled conditions. They’re very noisy. This is even assuming Froome has detailed records of how much he inhaled and when, and that his word should not be challenged. While the Heuberger model can certainly deal with this—there’s no requirement that each sample be taken at the same time after inhalation--it complicates the analysis if the samples aren’t uniform in this respect. Each sample has to be treated individually, and this introduces an additional error or degree of uncertainty when it’s compared to the others. This is beyond the substantial uncertainty already existing, e.g., in the time between inhalations and providing the sample.

The pool size might be greatly expanded—and the noise perhaps somewhat reduced--if Froome also introduced as evidence samples from other GTs, such as the TDF that preceded the Vuelta. But that assumes he has records for those stages, too, and all the other assumptions I’ve mentioned.

So this is a very difficult argument to make. Would it be enough to convince Haas, UCI, and WADA? The Heuberger model predicts about 15% of samples taken one hour after inhalation of 800 ug would exceed the 1000 ng/ml threshold,with about 10% exceeding the decision limit of 1200 ng/ml. I would guess roughly that the model predicts 7-8% would reach Froome’s level. If he took 800 ug regularly, within the last hour or two of a stage, he no doubt would have reached that level several times in the past. His argument has to be, first, that he has rarely taken 800 ug under those conditions, so rarely that he has never before reached even 1000 or at least 1200 ng/ml. And second, that he has reached an equivalent level at times. E.g., if he has a large pool of samples from when he took 2 puffs, several reach 400-500 ng/ml, while the others describe a descending range of lower values.

Perhaps Froome really was able to provide these data, credibly. But until I see the details, I remain deeply skeptical that a) he has records that are detailed enough to use in such an analysis; 2) that enough of the samples were taken within an hour or two of the inhalations, so as to reduce the uncertainties associated with dealing with multiple time points; and 3) his range of values really deviates so much from what has been reported in the literature.

There is one final point I made very early in this thread. If Froome has rarely taken 800 ug in the past, so rarely that he has never exceeded 1200 ng/ml, then it's quite unlikely that the one time he would exceed it, he would do so dramatically, to 2000 ng/ml. That is statistically improbable in a random distribution. While it's true his corrected value was about 1400 ng/ml, until this year, the correction was not allowed. So the 2000 ng/ml level is directly comparable to whatever he recorded in the past. When we say that Froome never exceeded 1200 ng/ml in the past, we mean uncorrected. If he had exceeded that limit, a high USG would not have helped him, by the rules that were then in force.

Speaking of which, don't forget that the correction for SG was only instituted this year (and after Froome's AAF). Had such a correction not been allowed, as was the case in previous years, I doubt that even the Heuberger model could have saved Froome.

Lucky? That he was busted in 2017 and not an earlier year. That his AAF was leaked, stimulating Heuberger et al to do their study. That he has the resources to make this case, obviously.
 
Oct 14, 2017
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armchairclimber said:
Well that and the lack of benefit conferred to otherwise healthy riders. I suspect that the thyroid meds that are just as easy to abuse confer more.


How about as a masking agent for other stuff?
 
Mar 29, 2016
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Yep, without WADA's rule change 1 March, Froome would have had severe problems. Wonder who pushed for this?
https://www.bbc.com/sport/cycling/42417297
Being dehydrated can increase the concentration of a drug in the system. And that could be the reason for Froome's test result, says Dr Tom Bassindale, an anti-doping scientist at Sheffield Hallam University.

In the past, Wada has not adjusted the salbutamol threshold in test results to account for "high urine density", which can increase when you are dehydrated.

But that is changing from 1 March 2018, and a Wada spokesperson told BBC Sport that for any case currently being adjudicated, "the most beneficial rule to the athlete would apply".

So if Froome qualified for this adjustment, a correction equation would bring his 2,000ng/ml reading down.

It might still not be nearly enough to come down under the threshold - an athlete would likely need to be severely dehydrated for the equation to have such a drastic effect as halving a result.
 
Oct 14, 2017
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Robert5091 said:
Yep, without WADA's rule change 1 March, Froome would have had severe problems. Wonder who pushed for this?
https://www.bbc.com/sport/cycling/42417297
Being dehydrated can increase the concentration of a drug in the system. And that could be the reason for Froome's test result, says Dr Tom Bassindale, an anti-doping scientist at Sheffield Hallam University.

In the past, Wada has not adjusted the salbutamol threshold in test results to account for "high urine density", which can increase when you are dehydrated.

But that is changing from 1 March 2018, and a Wada spokesperson told BBC Sport that for any case currently being adjudicated, "the most beneficial rule to the athlete would apply".

So if Froome qualified for this adjustment, a correction equation would bring his 2,000ng/ml reading down.

It might still not be nearly enough to come down under the threshold - an athlete would likely need to be severely dehydrated for the equation to have such a drastic effect as halving a result.


How much money did it cost to get that rule changed? Obviously this was specifically for him and to protect him.
 
Mar 29, 2016
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Oh, what this smells funny -
Dateline - 7 September 2017 Froome gives sample at Vuelta with high Salbutamol level
15 November 2017 WADA writes technical document about "Measurement Uncertainty"
3 May 2018 Heuberger report "Futility of current urine salbutamol doping control" (who paid for this study?)
2 July 2018 UCI closes Froome's case
 
Jun 30, 2009
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The supposedly 'unique circumstances' of Froome's case may not be as unique as WADA claims they are. 2015 Tour:

Froome was on track to win his second Tour de France this July when he fell ill. The Team Sky rider went into the final week with a 3:10 lead over second place Nairo Quintana (Movistar). That was reduced to just over a minute by the time they reached Paris at the end of the week. He lost most time on the final mountain stage to l'Alpe d'Huez and said afterwards that he was close to losing the race.

Trying to avoid showing any signs of weakness, Froome said he resorted to holding his breath so as not to cough in front of his rivals. It wasn't until one keen-eared journalist noticed a change in Froome's voice following the penultimate stage that he admitted he had been ill throughout closing stages.

" woke up all congested, blocked up, sore throat and I could feel it getting down into my chest, sort of tightening it. I was put on a short course of antibiotics but it had no effect. I was trying to hold it in, so my rivals wouldn't hear me coughing and wheezing . . . the most difficult times were on the start line where I had [Nairo] Quintana on one side, Contador on the other," Froome explained.

"I would be standing there with a burning sensation to cough or needing to get some phlegm up, but I would hold my breath to stop myself. I didn't want them to see I was battling with this. Just don't let them see anything. I couldn't wait for the neutral zone so I could get to the side of the road, blow my nose and get it all up."


Some of the 'unique' circumstances according to WADA:

illness, use of medication, chronic use of Salbutamol at varying doses over the course of weeks of high intensity competition

So illness and use of medication are not unique for Froome. The timing of the illness is also practically the same, third week of a Grand Tour.

Seeing as though he claims to have suddenly fell ill, it seems reasonable to assume that he would have increased his salbutamol dosage.

Yet in spite of all these similarities, Froome never exceeded the threshold in 2015 according to what is publicly known.
 

thehog

BANNED
Jul 27, 2009
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Re:

Robert5091 said:
Oh, what this smells funny -
Dateline - 7 September 2017 Froome gives sample at Vuelta with high Salbutamol level
15 November 2017 WADA writes technical document about "Measurement Uncertainty"
3 May 2018 Heuberger report "Futility of current urine salbutamol doping control" (who paid for this study?)
2 July 2018 UCI closes Froome's case

Agreed. The measurement uncertainty document appears to what have saved him bringing down his level to a point where they could argue away the rest.
 
May 26, 2010
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thehog said:
Robert5091 said:
Oh, what this smells funny -
Dateline - 7 September 2017 Froome gives sample at Vuelta with high Salbutamol level
15 November 2017 WADA writes technical document about "Measurement Uncertainty"
3 May 2018 Heuberger report "Futility of current urine salbutamol doping control" (who paid for this study?)
2 July 2018 UCI closes Froome's case

Agreed. The measurement uncertainty document appears to what have saved him bringing down his level to a point where they could argue away the rest.

Can all athletes now claim "Measurement Uncertainty"?
 
Aug 9, 2012
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Re: Re:

Benotti69 said:
thehog said:
Robert5091 said:
Oh, what this smells funny -
Dateline - 7 September 2017 Froome gives sample at Vuelta with high Salbutamol level
15 November 2017 WADA writes technical document about "Measurement Uncertainty"
3 May 2018 Heuberger report "Futility of current urine salbutamol doping control" (who paid for this study?)
2 July 2018 UCI closes Froome's case

Agreed. The measurement uncertainty document appears to what have saved him bringing down his level to a point where they could argue away the rest.

Can all athletes now claim "Measurement Uncertainty"?

Yes. Measurement uncertainty is one of the constants of measurement.
 
Mar 29, 2016
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Minutes from WADA's meeting Nov 2017
https://www.wada-ama.org/sites/defa...les/ecminutesnovember2017_final_published.pdf
Pages 42 of 47 has decision on the "Uncertainty Measurement" document TD2018DL
The Laboratory Expert Group had decided for those substances that the concentration in urine had to be adjusted for the specific gravity if it was above 1.020. That meant that it worked in favour of the athletes because, for concentrated urine in which the concentration would be higher, a correction for specific gravity had to be made. There was a minor technical modification regarding how the adjusted decision limits had to be expressed in terms of decimal places, because sometimes that made a difference to whether or not the finding was declared positive.
...
Another minor technical modification regarded the threshold for some of the exogenous threshold substances. It had been clarified that the threshold was based on the added concentrations of the parent compound, which was a phase-2 metabolite of such substances in urine.
 
Jul 27, 2010
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Measurement uncertainty refers to something else. The threshold of 1000 ng/ml is elevated to a decision limit of 1200 ng/ml to account for uncertainty in measurement. AFAIK, it's been in the rules for a long time. It's distinct from the urine specific gravity correction, which was put in place just last November. Also note that when it was, it was also stated that it could be in effect back-dated, so that it applied to any salbutamol AAFs that had been recorded prior to November, if the case was still in process. I'm pretty sure Froome's was the only case of this nature.

Notice the way the system bends over backwards to accommodate the athlete:

1) 800 ug inhalation allowed, though most doctors will say if you need that much in a short period of time, you shouldn't be riding
2) 1000 ng/ml threshold, though most studies indicate that 800 ug will not result in that high a concentration
3) 1200 ng/ml decision limit, to account for the worst possible uncertainty, which is unlikely
4) urine specific gravity correction, which allows the athlete to lower his salbutamol level if his urine is more concentrated than usual, but does not require him to raise it if his urine is more dilute than usual (ironic, because one of the arguments for the change was based on an unfairness in treating dilute samples)

Wrt Froome in 2015. He might well have taken the maximum allowed dose at that time, but one would not expect him to exceed the threshold or decision limit. His argument is not based on the notion that he would always exceed this limit if he took the maximum dose, only that it's possible on occasion. The real counter to that, as I've mentioned before, is that if this was the first time he exceeded the limit, it should not have been by so much.

Consider a simple analogy. You flip a coin one hundred times. Probability theory says that the odds of getting twelve heads in a row at some point in the sequence are about 0.01, so let's call that the threshold. The odds of exceeding the threshold are about 100:1. But if you exceed the threshold, the odds are that it won't be by much. Thirteen heads in a row has a probability of about 0.005, while sixteen heads in a row has a probability of roughly 0.0006. The odds of getting sixteen heads in a row are eight times lower than the odds of getting thirteen heads in a row. If you repeated the one hundred coin flips many times, you would eventually exceed the twelve in a row threshold, but the odds are eight times higher that you would first exceed it with thirteen in a row--exactly, no more--rather than with sixteen in a row.

This I believe is one of the most compelling arguments against Froome that hasn't generally been pointed out by salbutamol researchers. We don't know how many times Froome has taken 800 ug in the past. But--barring UCI coverups--we know he has never exceeded 1200 ng/ml. This is supposed to have been the first time he ever exceeded the limit. The odds of doing it with 2000 ng/ml rather than, say, 1250 or 1300 are like the odds of getting sixteen heads in a row rather than thirteen. I don't know exactly how low the odds are, but they could be estimated from Heuberger's model.

Edit: I now see that Rabin suggests other elements than variability:

“He took a certain number of medicines to treat it and other elements linked to his diet were also taken into account, as were dietary supplements. And other things too.”

https://www.cyclingweekly.com/news/latest-news/testing-hasnt-become-irrelevant-wada-science-director-defends-anti-doping-process-froome-case-384891

I did suggest previously that Froome's best shot seemed to argue that some drug he was taking slowed down the excretion process, but I dismissed this possibility based on what WADA said at its website yesterday. But maybe drug interactions were in play.

Rabin also claims that Froome's case is not completely unique, it's just that other riders got off without the case ever being public. But WADA's own stats put a ceiling on how many such cases there could have been, and it's not a lot.
 
Jul 27, 2010
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More on the case:

According to The Times, the team argued that most scientific studies on the excretion of salbutamol have been done over a single day, not over nearly three weeks of intense competition, and they built a statistical model showing the chances of a false positive for someone who is regularly using salbutamol and tested frequently, as Froome was when leading the Vuelta from stage 3 to the finish.

According to The Times, the UCI ran its own model and "discovered that there was an alarmingly high chance of a false positive". The UCI has not responded to Cyclingnews' attempt to verify this claim.

http://www.cyclingnews.com/news/more-details-of-chris-froomes-successful-salbutamol-defence/

I can’t wait to see what assumptions were used to build this statistical model. Because there clearly are no empirical data available. At least we know they didn't use data from dogs, either.

It will also be interesting to see why, if the chances of a false positive are "alarmingly high", a lot of other riders haven't tested positive. There certainly have been other positives in GTs--Petacchi, Piepoli and Ulissi--but since it's thought salbutamol might be useful in weight loss and recovery, it might be abused more in GTs. I'll also mention that all three of those riders tested positive about midway, not near the end, of a Giro. I've checked on a few other known salbutamol cases, with a couple of riders testing positive in very short stage races (3-4 stages), one in what I think was a one day race, and one in the offseason.

Another note: While the just "15 AAFs out of 200,000 tests" is making the rounds, remember the only tests that are relevant are of athletes who have asthma and take salbutamol. So it's not really 200,000 tests but maybe roughly 10% of that, I guess, with some sports, like cycling, clearly having a much higher percentage than others. Still a very small amount of positives. The same point was made by expert witnesses in the Petacchi CAS case, scientists who had actually been responsible for testing samples:

Dr Botré, who had been Director of the Rome Laboratory since 1999 and Director of the
Olympic Laboratory at the 2006 Turin Olympics, gave evidence of the rarity of finding a
Salbutamol concentration as high as that found in the present case. He stated that in the last
nine years at the Rome Laboratory he had had overall responsibility for checking 60-70,000
samples for Salbutamol,of which about 80% were from athletes in competition. Only about
five or six samples had been found to contain a concentration of more than 1000 ng/ml of
Salbutamol. At the 2006 Turin Olympics, he had tested about 1,450 samples from athletes and
found Salbutamol in about 16 or 17 samples. All of these had contained less than 300 ng/ml of
Salbutamol.

https://jurisprudence.tas-cas.org/Shared%20Documents/1362,%201393.pdf