Absolutely, but I think the burden of proof in anti-doping is sky high, to the point that I believe they look past thousands of test results that I would be happy to assume guilt based on.
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Thanks!
If the biopassport worked the way it’s supposed to, to not raise red flags a rider‘s rider’s data in using this method would have to show a fairly steady state through out-of-competition testing and testing during races. Would that mean ongoing use of carbon monoxide throughout the year? I don’t think the studies have shown what the health effects would be?
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Good point, I was basing that on the hypothetical of a valid biopassport system
Testing for natural EPO is a common procedure, in fact getting EPO for anemia disorders requires getting the native EPO levels tested beforehand. It’s an insurance requirement for some illnesses.
HCt boost from altitude-caused hypoxia decreases steadily on return to sea level and the blood level returns to “normal” by the end of two weeks at the most. Perhaps there are longer lasting benefits of training at altitude for performance improvements when racing up 2,000+ meter cols during a GT, but that would not be from the original HCT boost.
I'll paraphrase the parts of Lars Nybo's answers which I found interesting from the podcast episode Pozzovivo linked to:
Lars Nybo is introduced as among other things being a top expert on heat training.
Lars Nybo is introduced as among other things being a top expert on heat training.
At the end when asked about it he says that he's always found San Millan to have no idea about training. That what he says is nonsense! Mou described massive improvements in training...
Very interesting. In particular the stuff about San Milan. Many people have said that he is not an elite level coach - for years. Must say i'm very surprised that UAE had so much faith in him if this was widespread knowledge. They seem to be so excellent at developing the team (of course the money makes it all possible) but still. The colnago bikes, the aero setup etc have taken masive leaps forward since 2021. Why stick with a clueless coach for so long? Seems a bit weird no?
I'm sorry for going on and on about this but:
I'm very sceptical about the "limit of human performance". Nybo don't know what the limits are, that is simply not true, particularly if you look at the scientific knowledge that he consumes and produces. To know that, he must gather an enourmous representative sample of the world population, and apply a plethora of training regimes to different sub-groups of that sample. And then he can only make an estimation of what outliers may be out there in the human population. In reality there may be 100's of people who are much greater talents than Pogacar. It's wild but statistically very likely. I read all the top Sport science journals. None have ever claimed to know or present what is possible for humans. ONLY what is a reasonable estimation of the ceiling for the people within the sample they have at hand.
No sport is close to draining the talent pool that is really out there imo. Football (soccer) obviously comes the closest given the share number of people who play from an early age. Then again - very different sport with different demands.
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To be fair to him, that was sort of what he said - and most likely what he meant. They're about at the edge of the fitness levels that have been measured.
Well, as far as I know the claims coming from San Millan and his riders about their training have been preposterous, haven't they? And I do have a feeling that UAE was originally very unprofessional, and have slowly moved away from that. Also my gut (trustworthy source, I know) tells me that they're still tactically pretty simple/stupid. Chaos when they have more than one leader. But they can get away with a lot because they have the best rider in the world, and half of the top 20 climbers or something like that. (And because they spend a lot of money on doping - alledgedly; as in alledged by me, right now.)
So I guess I do think San Millan is actually just a really awful coach??? lmao
But the issue is not so much about what is possible human population wise. In endurance sports, whatever the ceiling is will essentially be regulated by oxygen availability in the working mitochondria to sustain high rates of ATP production. Intensity and duration will be linked via the power curve.
It is rather about how did the current top end of the WT population gain around 10% more aerobic capacity in a matter of years after the early Covid pandemic (on top of already exceptional values). Or even between 23 and 24.
(If I were to sell this ffwd evolution story to mamils who want to believe, super special training would be the way.)
It is rather about how did the current top end of the WT population gain around 10% more aerobic capacity in a matter of years after the early Covid pandemic (on top of already exceptional values). Or even between 23 and 24.
(If I were to sell this ffwd evolution story to mamils who want to believe, super special training would be the way.)
I can see your point but my comment was more meant as a general statement since so many tend to argue that above a certain w/kg is strongly indicative of doping. I belive they have no way of knowing that.
Everyone in the peleton are pushing their best ever numbers, not only the top guys. Teenagers and neo-pros are coming in and competing with the best. Whatever the playing field really is - it seems quite even to me. Except Pog and Jonas. Myabe also Remco but I just believe that he is that one in 20 million talent.
Why did their numbers increase so much the last years? Well the average numbers these days are much better than 2019 and before. Not sure why. It's multifactorial for sure, and doping may play a small role if a role at all. We have simply no evidence of doping except big performances. Why did Pog and Jonas level up this year? That is what I am trying to find out and people are not given credible evidence for doping in here or anywhere else. The carbon monoxide inhalation is the only smoke so far.
Even believers (in clean cycling) like myself find what happened on stage 15 of the tour this year uneasy. But Pog has been good for years and to be honest - almost all riders tend to make a leap forward when they reach mid 20's compared to their level in early 20's. The 1996 generation had a lot of people last year making big steps forward. It is not inconceivable that also Pog can improve a lot when he reached physical maturity. JV may be a special case or something. Incredible rise in level from age 20-23 to 24-26 and now again at 27. Maybe i'm just blind.
Widar and Torres and Seixas are pushing crazy numbers to as 18 years of age. I really don't believe that Lotto and Decatholon have them on a doping program or something. That seems wild and unfair to suggest. UAE? I trust the leadership there much less. Which I think is only fair.
I am more at 50/50 at the moment. Although Peter Attia is a fan, San Milan's "zone 2 training" is not very sophisticated so I can imagine that a new trainer has some low hanging fruit to work with and can improve the riders in the team but then again this takes time and you can't add 5-10% in watt/kg to pro cyclists in a year.
Does anyone know how exactly is this CO rebreathing working. Is it a lungful once per day or does one need to sit there with a mask on for (say 10min)? And, I guess, each breath would have a certain amount of CO in it (was it about 0.001 mmol?) ?
Maybe not with training alone but everything interacts with everything else. Felix Gall made a 10% increase last year. Lennert Van eetvelt have done so this year. So have Palayo Sanchez. Derek Gee? There are many many examples of this. Breakthroughs happen. It's rare to see the best guys level up again but JV did that between tour 2021 and 2022. Geraint Thomas did that back in the day. Froome improved what 15% at least in 2011. I think it happens.
Chrstophe Laporte improved his climbing level at least 10%. Doesen't mean he is doping - most believe he is actually training a lot better in visma than he was in cofidis.
Me and E_F and others have posted about earlier in the thread. Read page 73. There are some suggestive studies but they are very weak on scientific grounds and hard to draw any conclusions from. The inhalation protocol is super intense. Read the papers for the exact methods.
"For this purpose, subjects inhaled a predetermined CO bolus five times per day, starting at 8 am and then every 4 h until midnight. Subjects were allowed to sleep from midnight to 8 am without taking a CO bolus. The placebo group inhaled an ambient air bolus instead of CO from identical syringes on the same time schedule"
I guess it is quite a small dose since it is administered from a syringe, but idk.
I come from a different field and, in general, I find medical studies quite underwhelming, both statistically and methodologically. I mean, 11 people... It is very hard to draw any conclusions from such a small sample size. Additionally, they assume every parameter has a Gaussian distribution and I do not believe they ever thought of making a Lilliefors test.
All this being said, it seems that there might be something there and it seems to me it would be quite easy to conduct a proper study. The relevant bodies should then make a statement if it should be allowed.
Yes, WADA considers them experts. However, when you look at their credentials it is not nearly as clear.
Yes, they all seem to make regular appearances in very questionable cases. Almost as if having them review the data increases the chances of an adverse finding.
Furthermore, Morkenberg & Paixao have expertise in clinical hematology & Lewis expertise with hypoxia's effect on the hematological parameters of the ABP. All three have served as anti-doping experts at many Tribunal hearings as well as testified at many CAS hearings, some involving high-profile cases from athletics.
This is a lie. Sample 6 was within the biological passport limits for reticulocyte percentage and OFF-score.
Again, if you look at the original post, why is it that the expert panel are the ones deciding which argument is correct. We asked many times for an independent review, but the expert panel refused. Any competent scientist would have rejected their arguments. It is worth re-emphasizing that multiple people have reviewed the biological passport for Robert Stannard, and only that expert panel deemed it indicative of doping.
The UCI claims to not keep records of previous reviews, but this would have been at least the third expert panel to review the data if the UCI was following their regulations. The previous two apparently did not come to the same decision. The other scientists we consulted with- including some involved with the creation of the blood passport- labeled the expert panel's decision "a joke." There is a reason that Bahrain's scientific team did not see evidence of doping.
Again, note that the judge relied on the "expert panel" to judge whether the defense's arguments were valid. A judge, with no scientific background, basically told us before the hearing that the expert panel's opinion were all that counted. As I said before, a kangaroo court.
I was not allowed to point out that the relatively small number of ADRV actually makes it less likely that the biological passport in question was a true positive. This is just Bayes' theorem: if you compare the number of positive findings with the predicted number of false positives, the number of false positives is far greater.
I will continue in another post with examples of just how bad the expert panel were with statistics.Remember when the test for rEPO was developed in 2000, there was a dramatic shift to blood transfusions IC (see Lance Armstrong's systematic doping regime with US Postal during the Tour). Until the ABP was developed, there was no way of detecting blood transfusions. The UCI utilized the 50% Hct upper-limit rule which only resulted in a two (2) week no-competition down time period. And this rule certainly didn't do much for the athletes that had low baseline Hct levels that could dope right up to the limit & have a significant advantage in competition.
One of Schumacher's excellent papers on the basic fundamentals of the hematological module of the ABP covering both transfusions & ESA use:
Detection of EPO doping and blood doping: the haematological module of the Athlete Biological Passport - PubMed
The increase of the body's capacity to transport oxygen is a prime target for doping athletes in all endurance sports. For this pupose, blood transfusions or erythropoiesis stimulating agents (ESA), such as erythropoietin, NESP, and CERA are used. As direct detection of such manipulations is...pubmed.ncbi.nlm.nih.gov
The PDF on the Tribunal hearing:
Statistical mistakes."The "expert" panel (3 mediocre at best scientists)?" Are you kidding? The three experts on the panel: 1) Dr Jakob Morkenberg 2) Dr Laura Lewis 3) Dr Paulo Paixao.
Lewis & Morkenberg are on the board of WADA's Hematological Athlete Biological Passport Working Group which is chaired by renowned anti-expert Olaf Schumacher. The board provides expert advice, recommendations & guidance with regards to the hematological module of the ABP:
Furthermore, Morkenberg & Paixao have expertise in clinical hematology & Lewis expertise with hypoxia's effect on the hematological parameters of the ABP. All three have served as anti-doping experts at many Tribunal hearings as well as testified at many CAS hearings, some involving high-profile cases from athletics.
The anti-doping experts noted sample #2 (OFF-score: 123.1) was taken at the start of the Tour de l'Avenir & sample #6 (OFF-score: 122.01) was taken one week after the national championships. These by far were the two highest OFF-scores on the profile, both meeting the 99% specificity.
All of your points & challenges were addressed by the anti-doping experts citing case studies throughout the hearing. I'm not going to go over each one here - people can read the hearing in it's entirety. I will note that under paragraph #35, the anti-doping experts unanimously concluded that none of your arguments "provided any credible explanation for the abnormalities observed on the profile."
Additionally, the Judge in the case concluded in paragraph #230 that based on the evidence presented, she was "comfortably satisfied that the rider committed an ADRV."
Btw, the ABP has been challenged numerous times over the years in CAS hearings. Paragraph #200 cites & summarizes some of those challenges - concluding that the ABP is "a reliable means of evidence for the purpose of establishing the use of a prohibited substance or method."
The ABP (hematological module) has been in use since 2009. There are over 180 ADRVs as a result of hematological anomalies. A high percentage of these cases come from athletics with Russia leading the world in ABP hematological anomalies bans with over 70! It's the only reliable method to detect blood transfusions & the off-phase of use of an ESA where the doper avoids testing positive but has hematological anomalies still present.
Remember when the test for rEPO was developed in 2000, there was a dramatic shift to blood transfusions IC (see Lance Armstrong's systematic doping regime with US Postal during the Tour). Until the ABP was developed, there was no way of detecting blood transfusions. The UCI utilized the 50% Hct upper-limit rule which only resulted in a two (2) week no-competition down time period. And this rule certainly didn't do much for the athletes that had low baseline Hct levels that could dope right up to the limit & have a significant advantage in competition.
One of Schumacher's excellent papers on the basic fundamentals of the hematological module of the ABP covering both transfusions & ESA use:
Detection of EPO doping and blood doping: the haematological module of the Athlete Biological Passport - PubMed
The increase of the body's capacity to transport oxygen is a prime target for doping athletes in all endurance sports. For this pupose, blood transfusions or erythropoiesis stimulating agents (ESA), such as erythropoietin, NESP, and CERA are used. As direct detection of such manipulations is...
The PDF on the Tribunal hearing:
For sample 2, the Hb value for the rider was 16.8. For the biological passport, the predicted mean was 14.75, plus or minus 1.75. This means the limits were between 13.00 and 16.50. The rider's Hb was outside this limit.
The expert panel agreed that the rider had spent five weeks at altitude, and they proposed that this would shift Hb by 0.80. Using valid statistical principles, this would shift the predicted mean to 15.55. The variability would also increase to account for the variable response to altitude, but just assume that variability stayed the same (this is being very generous to the expert panel). In that case, the limits would be 13.80 to 17.30, and the test would be within the limits.
Here is what the expert panel did. They adjusted the predicted mean to 15.55. Then, assuming no variability (i.e. that there would be effect of diurnal variation, no measurment or storage error, no effect of hydration status, etc.). And because Stannard's Hb was over 15.55, they concluded it indicated doping.
By their analysis: a) any value other than 15.55 would have been considered doping- you really need to have some variability; and b) a factor (altitude exposure) which is known to increase Hb, with the expert panel's analysis, they lowered (not raised) the acceptance limit for Hb.
This is unbelievably stupid. Any undergraduate science student would know better, but three "experts" got it wrong- and laughably wrong. But they decided they were right.
For the effect of age, the expert panel said that an adjustment of plus 0.3 was warranted. This would also put the Hb within the allowable limit, but to the expert panel, this just meant raising the limit to 15.05.
The same was true for the OFF-score. For this, the expert panel did not give any adjustment (odd, given that they were supposed to have the burden of proof). The rider's OFF-score was 123.10. The predicted mean was 88.90, plus or minus 27.55 (some rounding error), resulting in an acceptance limit between 61.34 and 116.45. From the literature that the expert panel cited, the average OFF-score increase from a similar altitude exposure was 11.20. If you crease the upper and lower limits by this amount, you get an interval of between 72.54 and 127.65. And, therefore, within the limits. But the expert panel disagreed, without giving their own statistical analysis.
So, in summary, with competent statistical analysis neither sample 2 or sample 6 was outside the limits. That might be why no qualified person other than the expert panel looked at the passport and judged it to be indicative of doping.
Do you maybe see why I question the competence of the expert panel? This is amazingly bad, and they get away with it because there is no competent external review. All they had to do is decide that they were right.
Quite interesting!
In adjusting the predicted mean for altitude, did the panel also adjust the variability (standard deviation) of Hb levels? If so, how?
What criteria did the panel use to determine doping based on exceeding a certain confidence interval, standard deviation, or another statistical measure?
Did they use a specific model or formula, and how did they account for increased variability due to altitude?
The expert panel set the variability to zero- which is as ridiculous as it sounds. We, in our presentation and in our responses to the expert panel, used the variability from the biological passport without increasing it (as should be done to account for individual differences in response to altitude). That choice was made to show that even under the kindest assumptions for the prosecution, the Hb value was within the limits.
They say the expert panel gets to choose the adjustments "holistically". But the adjustments I gave for Hb were the ones suggested by the expert panel.
They never really put forth any justification (I'm not sure if I'm allowed to include the letters from the UCI) for either test. For test 2 it was that it was over the limit, and nothing else. For test 6, they tried: a) it was the minimum for the time series (a joke); and b) if sample 2 was removed from the biological passport, sample 6 would become outside the limit. But if we are in the business of removing inconvenient data points, I could remove sample 1 and make everything go away.
Thank you for answering!
If what you are saying is indeed the actual events, this is completely farsical on scientific grounds. So much so that it is hard to believe for us on the outside that the system is this bad. I almost want to invoke the meme "We didn't have high expectations (of UCI), but holy s***.
in case you haven't seen the full pdf posted above, here's the explanation given by the expert panel:
"After careful review and considering the most relevant scientific literature, the Expert Panel concluded univocally that Sample 2 HGB and OFFS values were still much too high to be explained by a stay and training at altitude in the two weeks preceding the sample collection, even considering the most favourable scenario to the Rider:
“According to the new information provided in Mr. Scott’s report, the athlete was at altitude until the 3rd of August 2018 e.g., the altitude exposure ended 14 days before Sample 2 was collected. To examine the potential impact of this altitude exposure on the blood values in Sample 2 we have first calculated the approximate altitude dosage according to Garvican-Lewis et al. 2016. Three pieces of altitude information each day from 07.07.2018 till 03.08.2.18 were presented in the report by Mr Scott; ‘accomodation altitude’, ‘average exercise altitude’ and ‘peak exercise altitude’. For the majority of days the altitude reported does not differ significantly between the three categories. Since we have no information of the average exercise time per day we have hypothesized that the athlete exercised for an average of 8 hours each day (which likely is overestimated, but will benefit the athlete in our calculation) except on the 16.07.2018 and 21.07.2018 where he rested (was anticipated to be at ‘accomodation altitude’) and that the remaining 16 hours were spent at the ‘accomodation altitude’. The total altitude dosage during the 28 days was calculated to 992 km.hr. There are several publications having examined the effect of altitude. Mr. Scott has mentioned some of these in his report, also some of which have reported results during the post-altitude period, which is the period of interest in this profile. Instead of picking only specific papers that potentially fits into the argumentation, a more scientifically correct way would be to use data from a meta-analysis, where all relevant data is examined together. Lobigs et al. 2018 provided such a paper in 2018. Here it is evident that the average increase in Hb 15 days after altitude is around 0.2 g/dL above the normal level, while the OFFscore on average is 3-4 points above baseline. Considering only values reflecting a similar altitude dosage (800-1000 km.hr) as the athlete, none of the subjects from the meta-analysis had elevations in Hbs above 1 g/dL or elevations in OFFscores of more than 20 points, 15 days post altitude. Considering all Hb values except Sample 2 and 6, the athlete’s average level is 15.0 g/dL and the average OFFscore is 99 (only considering samples analyzed with the XT1 excluding Sample 2 and 6). Hence the Hb in Sample 2 is 1.6 g/dL above average and the OFFscore is 24 points above average, which highly contrast the average increase of 0.2 g/dL and OFFscore 3-4 points and above the highest single values recorded in the Lobigs study."
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