ArmstrongÂ’s 2008-12 samples point to blood doping.

[Zigster]

i would have expected hematocrit to be much closer to 50%. Guess we're not living in the '90s.

 

[BroDeal]

It looks conclusive to me.

 

[Catwhoorg]

http://www.slipstreamsports.com/wp-content/uploads/2009/07/brad-wiggins-blood-profile-3.pdf

Brad's previous released data for comparison.

Note how apart from the one off score right at the end of the Giro - they fall into or just outside the 85-95 range.

Lance's 2009 values min 73.4 max 112, funnily enough just 18 days apart.

 

[asdfgh101]

You have to remember the Landis stuff had come out in May '10.

I would suggest he was watching his step. He did pull out of a number of races that year and his form was all over the place.

Aside from the 'altitude' spike the figures that stand out for me are those during or around the TDF. Minor fluctuations in Hb combined with low reticulocyte level.

What conclusions are you drawing from RVV 2010? Can you PM me if you don't want to post here (sorry for being obtuse).

 

[Anonymous]

Novel idea here....instead of doing their job in 2008, they wait until now because public opinion has turned on LA?

This doesn't coincide with what Tygart is spouting these days about fair sport and USADA doing their job. Maybe they should have done this in 2008.

I guess maybe it is all 'Political' after all...

When did that happen? I thought it was just a small echo chamber here in the clinic.

You and college need to get your stories straight.

This doesn't coincide with what Tygart is spouting these days about fair sport and USADA doing their job. Maybe they should have done this in 2008.

I'll go out on a limb here and speculate that if Tygart had the case in 2008 he has now we would not be having this "conversation."

 

[DirtyWorks]

Boom.

Paddy certainly has some 'splaining to do. No wonder Travis has kept this DB in the dark.

But, the **long** running problem is that the UCI is among other anti-doping shenanigans suppressing positives and no one seems to mind. At all! It didn't get any traction around Contador and that was an obvious failed attempt.

I hardly think everyone ignoring the possibility sports federations are suppressing positives is isolated to just cycling... This reaches all the way up to the very top of the IOC.

 

[Anonymous]

It looks conclusive to me.

I wonder if this graph will be presented in the proceedings?

 

[ScienceIsCool]

Fascinating data; and I love data. I'm a physicist by trade, and know practically nothing about haematology so I went to the web to see how "normal" these values are.

After looking at that graph of reticulocytes vs hematocrit, I decided that would be a good strating point. How to interpret that? What is usual and what is unusual? Are all those values within an expected range?

Several sources cite Reticulocyte Index as a useful measure. RI = reticulocyte count (%) * Hematocrit / "Normal Hematocrit Value".

The average hematocrit value for Lance Armstrong, based on the 38 samples, is a very normal 42.0%. Calculating his RI, I get:

mean = 0.91%
min = 0.49%
max = 1.49%

Furthermore, 25/38 (66%) samples give an RI <1.0%

According to many online sources (i.e., http://www.fpnotebook.com/hemeonc/lab/RtclcytCnt.htm), a normal RI is from 1-3%. It looks like Lance is a mild sufferer of Reticulocytopenia, or reduced blood cell production. There are a few nasty causes such as aplastic anemia and bone marrow suppression. These seem unlikely considering his seemingly good health.

Unfortunately for clean sport, a major contraindication is blood transfusion. In other words, the low RI can be explained by a blood transfusion. Worringly, the number of <1% samples indicate chronic transfusions over a long time period.

I'm probably missing other major contraindicators though. Any doctors want to chime in?

John Swanson

 

[mewmewmew13]

It looks conclusive to me.

LOL!!!!!

I am getting some wonderful laughs this morning!
This is hilarious...thank you

 

[Topangarider]

Fascinating data; and I love data. I'm a physicist by trade, and know practically nothing about haematology so I went to the web to see how "normal" these values are.

After looking at that graph of reticulocytes vs hematocrit, I decided that would be a good strating point. How to interpret that? What is usual and what is unusual? Are all those values within an expected range?

Several sources cite Reticulocyte Index as a useful measure. RI = reticulocyte count (%) * Hematocrit / "Normal Hematocrit Value".

The average hematocrit value for Lance Armstrong, based on the 38 samples, is a very normal 42.0%. Calculating his RI, I get:

mean = 0.91%
min = 0.49%
max = 1.49%

Furthermore, 25/38 (66%) samples give an RI <1.0%

According to many online sources (i.e., http://www.fpnotebook.com/hemeonc/lab/RtclcytCnt.htm), a normal RI is from 1-3%. It looks like Lance is a mild sufferer of Reticulocytopenia, or reduced blood cell production. There are a few nasty causes such as aplastic anemia and bone marrow suppression. These seem unlikely considering his seemingly good health.

Unfortunately for clean sport, a major contraindication is blood transfusion. In other words, the low RI can be explained by a blood transfusion. Worringly, the number of <1% samples indicate chronic transfusions over a long time period.

I'm probably missing other major contraindicators though. Any doctors want to chime in?

John Swanson

I'm not a medical doctor but found this useful.. .

http://www.sportsscientists.com/2011/03/biological-passport-legal-scientific.html

 

[thehog]

Unfortunately for clean sport, a major contraindication is blood transfusion. In other words, the low RI can be explained by a blood transfusion. Worringly, the number of <1% samples indicate chronic transfusions over a long time period.



John Swanson

Could you explain this paragraph in more detal? Is this dangerous? To be in a state of constant blood manipulation!

 

[Catwhoorg]

2009 in detail - with the races along the bottom.

HB falls dramatically during the Giro, so much that he would actually be defined as anaemic by the end. Then with 18 days it is suddenly his highest value for the year. However, there is not an increase in ret% which one would expect with a normal recovery (hence the large off score).

ret% remains low during the TDF, in fact gets lower still not quite dropping to an abnormal level,but very close. HB is a little all over the place (possible multiple small infusions ?)

After le tour HB and ret% shoot up (possible use of EPO ?), then there is a hue gap of 4 months with zero blood data.

In isolation, these definitely qualify as suspicious, even if they don't rise to the level of a passport violation, remembering the threshold for that is 99.9% certainty. It could corroborate other evidence/testimony.

I'd love to see Ashenden's interpretation though.

 

[ScienceIsCool]

Could you explain this paragraph in more detal? Is this dangerous? To be in a state of constant blood manipulation!

Oh no! As a complete layman, don't think I was making actual conclusions. Just that as someone who took a quick look at the numbers and their common interpretation, Lance appears to be chronically anemic. Given his good state of health, there should be some contraindicators. The common one being blood transfusions.

That's taking a very uneducated look at things. There may very well be an explanation that does not involve anemia or transfusions.

However, this view is consistent with the idea of Lance using blood manipulation over a long period of time.

John Swanson

 

[DonTickles]

What would we expect to see on the chart for someone if they were engaging in blood doping and microdosing EPO? Maybe someone can break it down for us a bit so we know what we are looking at better?

My speculation would be that Retic % would be highest after a blood draw as the body replaces missing blood with new cells. Is that correct? In that case you might suspect that a blood draw occurred between 30-Apr-09 and 7-May-09 due to the increase to 1.33%. Is there a known way to counter this increase? If Retic % is the percentage of reticulocytes to mature red blood cells then re-adding saline or plasma after the draw shouldn't affect this right? If retic % is a percentage of total volume then it would be easy to control. So which is it?

When blood is put back in you could control the drop in retic % with EPO microdosing to keep it from going too low. Lance's Retic % hits its lowest (of that general timeframe) between 2-July-09 and 11-July-09 around .54%. That's when you would expect him to be packing the blood back in and the body to slow down with red blood cell replacement. My question here is, why wouldn't they have increased the balancing EPO so there are fewer variations? My speculation is that they were seeking to keep the number within "normal" parameters and ignoring trends. "Normal" is apparently between .5% and 1.5%, so use just enough EPO to stay within that range and not trip any alarms, but use the least amount of EPO you can so it won't show up on the EPO test.

Am I on the right track with the retics?

What would be expected trends in off score? I thought it would trend higher when the doping is at its peak, but Lance's off score hits its peak in June, weeks before the tour.

Lastly, can anyone explain the MCV, MCH, and MCHC numbers and what irregularities could be expected when someone is doping or masking doping?

 

[mwbyrd]

It may be. But I'm hearing that they asked for the data for several years and didn't get it (note - just from multiple clinic comments, haven't seen any links). Are you specifically disputing that?

No, I'm not disputing that WADA and USADA asked for testing information from the UCI. But this is the first I've seen any talk about this situation. But if this is true, why wasn't this front page news? Imagine the headline: UCI refuses to give Drug Test results to WADA/USADA...

 

[Catwhoorg]

Don
ret% is the # of reticulocytes/red blood cell

Its done by an automated counter that picks up on a stain that picks up on the ribosomal RNA that vanishes in mature cells.

Saline/plasma etc do not affect it.

 

[DirtyWorks]

No, I'm not disputing that WADA and USADA asked for testing information from the UCI. But this is the first I've seen any talk about this situation. But if this is true, why wasn't this front page news? Imagine the headline: UCI refuses to give Drug Test results to WADA/USADA...

There is nothing WADA can request or instigate on their own.

The beauty of the WADA setup is the federation has the all the authority. Based on WADA findings the UCI (or any other federation) can accept or deny requests to open a case as they see fit. It's a one-way relationship with the federation having complete authority. This is by design and allows a free pass to any athlete favored by a federation.

In this case, the data was collected by law enforcement who had the authority to do so, and then passed to USADA. The federation was fortunately completely locked out.

This might not be entirely correct, so please post any useful corrections and details.

 

[BroDeal]

I still think looking at the blood samples as proof of doping is the wrong path. The data will be used to corroborate another rider's (probably Leipheimer's) account of how the team blood doped for the 2009 Tour. For 2010 they will have an account of doping for Flanders.

 

[iZnoGouD]

Lance doper

 

[egtalbot]

There is nothing WADA can request or instigate on their own.

The beauty of the WADA setup is the federation has the all the authority. Based on WADA findings the UCI (or any other federation) can accept or deny requests to open a case as they see fit. It's a one-way relationship with the federation having complete authority. This is by design and allows a free pass to any athlete favored by a federation.

In this case, the data was collected by law enforcement who had the authority to do so, and then passed to USADA. The federation was fortunately completely locked out.

This might not be entirely correct, so please post any useful corrections and details.

My only question would be that if what you outline is correct, why didn't WADA share the information with USADA in addition to UCI?

I'll be the first to admit that I have no idea what data USADA had when. And I have no idea when various rules were put in place for USADA in terms of the biological passport - I was under the impression that was a UCI invention initially. My gut tells me that the full scope of information they are using in the case - including witnesses, test results, etc - was not available until relatively recently. And that whatever results they did have 3 years ago they didn't consider actionable at the time.

I could be wrong, it could be a political,wind-shifting decision. In fact, I'd be surprised if there's not a small element of that. Makes no difference to me - if the data is there, they should proceed. If he were some bit player being singled out while everyone else walked, then sure, I'd consider it a problem. But if they've struck plea bargains with half a dozen others (and really we have no idea about that right now) to catch the most prolific TdF winner in history, I'm not going to lose sleep over it.

I think maybe this is getting slightly off-topic. I confess, I am interested in reading about the blood values but I don't know a lot about them other than the fact that as a very slow (by pro standards) cyclist, my own hematocrit has been in the 42-44 range previously when I've had blood workups for my physical. So I tend to not agree when the general media makes comments like a hematocrit of 45 is unusual. It's the change (and some of the other variables) that matter. Having it go up from 38 to 45 over a short period of time, now THAT'S unusual.

 

[Skibby the bush kangaroo]

There seems scant information on what the precise parameters used in the Biological Passport actually are. However, in "The Athlete’s Biological Passport and Indirect Markers of Blood Doping", Pierre-Edouard Sottas, Neil Robinson, and Martial Saugy, they say that the the normal limits for HCB are taken to be mean = 148, between-subject variance of 57.15 and within-subject variance of 28.22. Working on the basis that these limits are correct: Lance's HCB values have a very typical mean of 146, but unfortunately have a variance of 55.3 (i.e. much higher than 28.22).
Using the Bayesian updating approach of the ABP gives the following plots

The limits are pointwise 99%. I think these plots are quite generous because working on the basis of the sample variance you get a p-value of 0.0004, i.e. extremely unlikely by chance for a normal (i.e. non-doping) subject.

I will do some reverse engineering of some of the example profiles they give to try and work out what the initial prior values are for Off score and RET to get approximate plots and p-values for the other variables.

 

[Skibby the bush kangaroo]

OK here's my best attempts at limits for the off score and RET%.

For the off-score, the normal mean is about 81 with a between-subject variance of 95 and within subject variance of 73. Armstrong's mean is 90 and variance is 92. So slightly above average variability but within acceptable bounds, the resulting plot is:

For RET%, the normal mean seems to be about 1.3 with a between-subject variance of 0.04 and within variance of ~0.05. Armstrong's mean is 0.90 with a variance of 0.077. This variance is a little higher than might be expected by chance if not doping (p=0.02).

Basically in all cases there are no super anomolies but the level of fluctuation, particularly for the HGB, is a bit dubious.

 

[DirtyWorks]

My only question would be that if what you outline is correct, why didn't WADA share the information with USADA in addition to UCI?

Because, the WADA certified lab can only pass the info to the uci. If the uci opens a case, then it eventually goes to usada. the information is totally under the uci's control.
That is some good, (privacy) but mostly bad because Pat can sweep as many positives away as he likes with no repercussions. That's already happened at least several times that we know.

 

[Tyler'sTwin]

Hb and retics at the -09 TdF are a dead give away. No way that's normal. No effin way!

 

[asdfgh101]

I still think looking at the blood samples as proof of doping is the wrong path. The data will be used to corroborate another rider's (probably Leipheimer's) account of how the team blood doped for the 2009 Tour. For 2010 they will have an account of doping for Flanders.

Can you explain to me what the values for RVV 2010 would indicate?