Is the UCI's Biological Passport flawed?

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Jul 28, 2009
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Not sure if being ironic or not.

In another thread, far, far away, there is a "PhD" who has spent some time banging on about his mate "Asho" who has invented this ABP thing that proves there is no evidence Wiggins doped.

I saw the Science for Sports article but only just managed to get a copy of the study today, and I am aghast that this is the great white hope of anti-doping.

Yes yes anti-doping scandal JV mantra mantra mantra but ffs if someone posts that graph to prove clean peloton status or anyone suggests ABP is worth any more than ****ing into the wind for anti-doping measures I am going to have both barrels loaded for reply.

Good. Grief. :eek:

ETA: so you're saying there's no updated document that actually does anything to catch dopers? *sob*
 
Jul 28, 2009
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A little tidbit I found:
Hemoglobin concentration (Hb) is reported as grams of hemoglobin per deciliter of blood (g/dL). Since red cells are approximately 33% hemoglobin, the hemoglobin concentration of whole blood normally is about one third of the HCT (i.e., the MCHC is 33%).
So if someone has a Hgb reading of 16 g/dl, their Hct can be estimated to be up around 48%.

Also from that article:
Remember that hemoglobin-based oxygen carriers, like Oxyglobin, are red and are measured as hemoglobin with the cyanmethemoglobin method. This will always result in a high Hgb (compared to the HCT).
 
Jul 28, 2009
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Interesting to see how far we've come: March, 1997: http://www.sportsci.org/news/news9703/AISblood.html or http://autobus.cyclingnews.com/results/archives/apr97/10_4.html

Any of these names look familiar? The paper itself is a lot more than this - I have cherry picked parts of it that seem relevant to the current ABP, the fact that Ashenden was prepared to sign his name to this report. The "alleged use of rhEPO" (update after the summary below) seems strange, given the EPO test has only just, 15 years later, been confirmed.

Summary: the UCI made an attempt to do something so cyclists would stop dying from EPO use, and the Aussie scientists took them to task for it, for being too strict.

BLOOD TESTING FOR PROFESSIONAL CYCLISTS: What's a fair hematocrit limit?

David T. Martin, [Senior Sports Physiologist, AIS, 2012]
Michael Ashenden, [ABP specialist]
Robin Parisotto, [Anti-doping expert: http://www.cyclingnews.com/features/anti-doping-expert-parisotto-speaks-on-blood-passport]
David Pyne, [Senior Sports Physiologist, AIS, 2012]
Allan G. Hahn,
Department of Physiology and Applied Nutrition, Australian Institute of Sport, Belconnen, Australia


Attempts to Discourage Use of rhEPO
The news has made headlines on sport pages around the world. Both the Federation Internationale de Ski (FIS) and the Union Cycliste Internationale (UCI) have implemented random blood tests prior to competition to deter the alleged use of DNA-recombinant human erythropoetin (rhEPO), a hormone known to increase the rate of red blood cell production. These decisions have come after years of finger-pointing and unsubstantiated claims that some of the world's most competitive cyclists and cross-country skiers are receiving an illegal performance advantage by injecting rhEPO. The governing bodies for these two endurance sports have decided upon slightly different methods and cut-off values for screening blood samples. Whereas FIS have identified specific hemoglobin concentrations (16.5 g/dl women; 18.5 g/dl men), the UCI have decided to use a 50% hematocrit for male cyclists.
...
At their annual meeting in Geneva (24 January 1997), UCI delegates, in consultation with medical professionals, decided to implement blood testing to deter the alleged use of rhEPO by selecting a 50% hematocrit as an upper limit.
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No More Hematocrits Higher Than 50%
UCI president, Hein Verbruggen, has stressed that the testing is a " health check" and that a positive test does not imply rhEPO use. The testing has been primarily established to insure that professional cyclists will not begin a major road race with a dangerously high hematocrit
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But are there data indicating that a 51% hematocrit is dangerous for a professional road cyclist?

...

RhEPO Can Be Dangerous
It is now well recognized that the uncontrolled use of rhEPO can be dangerous. Within the first four years of rhEPO's introduction, this synthetic hormone was suggested to have caused over 17 athlete deaths (Ramotar, 1990).
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Why a 50% Hematocrit?
Although the UCI should be congratulated for their efforts to prevent the illegal use of rhEPO, the 50% hematocrit limit (approximately 16.5 g/dl) may be too aggressive and result in many false positive tests. The UCI cut-off is obviously much lower than the 18 g/dl hemoglobin limit selected by FIS.
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Hematocrits in Australian Road Cyclists
A retrospective analysis of 360 blood samples collected from Australia's top road cyclists between 1987-1996 resulted in 10 hematocrit values of 50% or more. Thus, 2.8% of blood samples from the Australian Road Cyclists exceed the 50% hematocrit value recently set by the UCI as an acceptable limit. It is believed that these cyclists were training and competing in a "clean environment" at the time of testing. In other words, it is unlikely that they were taking rhEPO. The maximum hematocrit 52.0%, recorded in one cyclist.
...
Hematocrits in Other Competitive Australian Athletes
A more detailed examination of the hematocrit data from all sports determined that the percentage of tests where hematocrit was greater than 50% ranged from 0.3% in netball to 25.7% in weight lifting. :eek:
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In Conclusion
However, the 50% hematocrit limit appears too aggressive on the basis of 10 years of data collected from road cyclists tested at the Australian Institute of Sport. A 52% hematocrit limit would result in fewer false positive tests and could still deter the suspected use of rhEPO

April 97. The UCI 50% Hematocrit rule has been implemented at the 1997 Paris-Nice Road Race. Three out of the 20 professional cyclists tested registered hematocrit measures greater than 50%. Their fate? An individual fine of 1,000 Swiss Francs and a team fine of 10,000 Swiss Francs. In addition, the riders with the "dangerously high" hematocrits were removed from competition for a period of 15 days. Erwan Mentheour (Fra, La Francaise des Jeux), Luca Colombo (Ita, Batik-Del Monte) and Mauro Santaromita are the riders who have lost money and a chance to win UCI points in Paris-Nice despite any evidence of rhEPO use.
This is a very different story to the one we are told. That Hein is the bad guy.
 
Jul 5, 2012
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April 97. The UCI 50% Hematocrit rule has been implemented at the 1997 Paris-Nice Road Race. Three out of the 20 professional cyclists tested registered hematocrit measures greater than 50%
15% of the sample tested positive for 50% HCT. In 1997.

Yet in 1998 we have the Festina Affair.

And in 1999 we have 2005 retrospective EPO testing revealing 13/97? or 15% positives (admittedly 6 were from a single rider - guess who lol).

I am guessing that they already knew in 1997 how to thin the blood to pass the test after taking EPO. As they say, the dopers are always five steps in front of the testers.

I am also guessing as the 50% is entirely arbitrary, perhaps Hein was happy having a slightly lower limit, more potential positives he could keep in his back pocket for a rainy day.
 
Jul 28, 2009
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the big ring said:
Perhaps the most disturbing thing for me with this graph is the reticulyte % between 2.4 and 3% is not shown. This is a graph in a published paper. There's a gaping hole in its representation.
Typo corrected in sport of science graph.

The science of sport graph is actually from Zorzoli's later paper:

Zorzoli M. The Athlete Biological Passport from the perspective of an anti-doping organization. Clin Chem Lab Med. 2011 49:1423.
 
Jul 28, 2009
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rata de sentina said:
Typo corrected in sport of science graph.

The science of sport graph is actually from Zorzoli's later paper:

Zorzoli M. The Athlete Biological Passport from the perspective of an anti-doping organization. Clin Chem Lab Med. 2011 49:1423.
Thanks. :D
 
Benotti69 said:
do away with passport. more testing. make the teams pay for it, min 10 out of competition tests a year per rider. there is no fix all, but a simple solution is longer penalties. min 4 year first time. no behind scenes dealing so riders get lesser penalites. Di Luca should not be back in the sport, it sends out the wrong message, you can get caught 3 times in a career and still do very well from the sport.

that has a benefit of scaring the bejeebus out of athletes who spent 6-8 years training and racing before becoming a pro to risk throwing that commitment away. Also there needs to be sanctions to teams or the teams DS and doctors. more than 3 riders on a team dope and lose automatic invitations to major races. this **** and bull that the riders do it themselves does not wash with me.

but this is all theory. no solution is possible while the headless chicken that is P McQuack is running the UCI........
Aside from the first line, this is the first time on this forum that I pretty much agree with you.
 
Sep 29, 2012
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In June of 2009, Robin Parisotto, the man who came up with the test for EPO that was used at the Sydney Olympics, who sits on the UCI ABP panel, said this, keeping in mind he sees the dodgy passports, and has a good handle on blood manipulation:

http://www.cyclingnews.com/features/anti-doping-expert-parisotto-speaks-on-blood-passport

CN: The Tour de France will start soon. Are you confident that the sport is cleaner than in the past?

RP: Well, if you compare it back to 1998, absolutely it is cleaner. There are a number of reasons. One – you have not only got blood testing used as a tool for anti-doping thanks to the passport, but you have other information through police or customs and that sort of stuff. So the actual tool to detect doping has increased from a drug test to two or three other methods to detect cheating.
Oh good. 2009 is cleaner than 1998, Festina affair.
 
Oct 16, 2010
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The Hitch said:
from that article, i caught a link to this abstract:
Blood doping practices in sports have been around for at least half a century and will likely remain for several years to come. The main reason for the various forms of blood doping to be common is that they are easy to perform, and the effects on exercise performance are gigantic. Yet another reason for blood doping to be a popular illicit practice is that detection is difficult. For autologous blood transfusions, for example, no direct test exists, and the direct testing of misuse with recombinant human erythropoietin (rhEpo) has proven very difficult despite a test exists. Future blood doping practice will likely include the stabilization of the transcription factor hypoxia‐inducible factor which leads to an increased endogenous erythropoietin synthesis. It seems unrealistic to develop specific test against such drugs (and the copies hereof originating from illegal laboratories). In an attempt to detect and limit blood doping, the World Anti‐Doping Agency (WADA) has launched the Athlete Biological Passport where indirect markers for all types of blood doping are evaluated on an individual level. The approach seemed promising, but a recent publication demonstrates the system to be incapable of detecting even a single subject as ‘suspicious’ while treated with rhEpo for 10–12 weeks. Sad to say, the hope that the 2012 London Olympics should be cleaner in regard to blood doping seems faint. We propose that WADA strengthens the quality and capacities of the National Anti‐Doping Agencies and that they work more efficiently with the international sports federations in an attempt to limit blood doping.
http://www.ingentaconnect.com/content/bpl/bph/2012/00000165/00000005/art00008
 
I think it’s this one: http://www.ncbi.nlm.nih.gov/pubmed/21336951

The Athlete Blood Passport is the most recent tool adopted by anti-doping authorities to detect athletes using performance-enhancing drugs such as recombinant human erythropoietin (rhEPO). This strategy relies on detecting abnormal variations in haematological variables caused by doping, against a background of biological and analytical variability. Ten subjects were given twice weekly intravenous injections of rhEPO for up to 12 weeks. Full blood counts were measured using a Sysmex XE-2100 automated haematology analyser, and total haemoglobin mass via a carbon monoxide rebreathing test. The sensitivity of the passport to flag abnormal deviations in blood values was evaluated using dedicated Athlete Blood Passport software. Our treatment regimen elicited a 10% increase in total haemoglobin mass equivalent to approximately two bags of reinfused blood. The passport software did not flag any subjects as being suspicious of doping whilst they were receiving rhEPO. We conclude that it is possible for athletes to use rhEPO without eliciting abnormal changes in the blood variables currently monitored by the Athlete Blood Passport.
You can get some or all of the full article at: http://link.springer.com/article/10.1007/s00421-011-1867-6 (it’s beyond a paywall, but sometimes the first few pages come up, and sometimes everything)

See also this: http://www.ncbi.nlm.nih.gov/pubmed/19903320
 
Oct 16, 2010
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King Boonen said:
Thanks, I can get the whole thing so will have a read tonight.
if you can get hold of the Bengt Salton article that I linked above, it's worth a read as well. One sections reviews the Ashenden evidence.
The overall sentiment in the Salton et al. article is that the ABP is too easy to circumvent (they also explain how, e.g. by microdosing or by taking very regular doses throughout the year, but that's nothing we didn't know yet). They also point out that for the ABP to work, (very) regular testing (particularly also OOC testing) is needed. But even then, it remains relatively easy to circumvent the system.

Ow, and even if you dope with rhEPO without actively trying to circumvent the ABP, there is still only a 20% chance of getting flagged.

In addition, they note that the ABP too often leads to false positives (not often, but still too often). Interestingly, they plea for opening more ABP cases based on indirect evidence, but because of the high false-positive rate also argue that punishments should be smaller (i.e. less than two years in case of conviction).

Bottom line after reading the article:
you gotta have your head deep in the sand if you think the top-end of procycling have stopped blooddoping.
 
The Hitch said:
Interesting discussion.
Whats your take on it Merckx index and King boonen. You agree with what Ashenden is saying ?
Hi Hitch,

This is really not within the realm of my expertise in the most part but I'll try and assess it. Hopefully Merckx Index can point out any errors I make/discuss it with me.

I've just read it. The paper does clearly show that under controlled micro-doping the ABP software will not flag the results from the study as abnormal over the time period. It's important to point out they were testing the ABP software, they didn't say whether an expert panel would determine if they were doping or not. There was also no control group (but I don't think that's required as they results weren't being manually assessed).

There are some other important things that came up that some may not be fully aware of, I certainly wasn't. The ABP software "learns" the data for individuals, they don't just use population baselines and then set 99.9% limits. This means that abnormalities are specific to the individual and so arguments that trained athletes are different to the general population aren't ever going to be valid.

They also point out that too many tests will cause the profile to follow the inherent testing errors (typical error of 2.8%) and make the data unusable. The accepted number of tests at the moment seems to be one a month, which apparently is what cyclists are currently subjected to. So when we say they need to increase testing we are wrong, they just need to make sure it is regular (They can of course increase testing for other things and just pick and choose which ones to use for the passport).

There are some major flaws in the study though, most of which they acknowledge at the end of the paper. The ones they acknowledge are that this study was extremely well controlled and it is difficult to say if a cyclist "in the wild" would be quite so methodical in the doping. EPO doping is cumulative in effect, so if a cyclist were to over-dose (not in the OD, junkie dying sense but in the too often with the micro-dosing sense) then they could easily flag up in the software. This leads to the old discussion of is the doping a team programme with full time doctors involved taking measurements or is it individual with a cyclist doping on their own based on a programme draw up by an external doctor, but without sophisticated monitoring, which is more likely to go wrong and cause a positive.

They also acknowledge that they do not include a wash out phase and say that if they did this would could likely trigger an abnormal result. They say this was deemed to be requiring too much from the subjects. This may have been the ethics boards decision, but I have to say this is... very surprising for reasons I can't discuss.

This paragraph is my opinion, not stated in the paper. The main point I take from this paper is that cyclists would have to use a maintenance doping programme, Doping for training and then not doping in races would most likely trigger an abnormal event (as long as the testing is carried out regularly). With the no needle policy this does mean that it would be more difficult for cyclists to micro-dope than we think as they would probably have to do it during a grand tour to maintain the expected levels (although this would have to be balanced with expected falls).


The flaw they don't acknowledge is that they started testing at the same point as they started doping. The tests were before injections but this means that they had one baseline result to train the software. As the software learns the profile I suspect that it didn't flag as abnormal because the changes observed had nothing to be compared against so the software was more forgiving. It would be much more interesting if they had done this with 2 or 3 samples taken before doping started. I suspect that would have caused the software to flag up the data much quicker.


It's a good paper, it shows that if someone is doping it can take over three months for the software to flag the profile but it is severely limited as it assumes doping started when the testing did and it does not show how long someone could get away with it, basically carrying out the study util completion (The important part in my eyes).

In other words, it's perfectly possible every subject would have been flagged after another one or two months if doping continued at the same level or was stopped (I'd say it was extremely likely this would be this case), it just wasn't flagged over the time of the study.

If a cyclist were maintaining a high Hb with doping then they wouldn't flag as abnormal, but we know that anyway. That has the inherent problem that they would probably have to dope during competition.


To me, all the paper really seems to show is that ABP flags are likely to be slow, but we knew that anyway. It also highlights that there must be regular testing (but interestingly not too regular). It also seems to indicate to me that someone could not beat it without a doctor/someone being involved to make sure they remained at the right levels.
 
sniper said:
if you can get hold of the Bengt Salton article that I linked above, it's worth a read as well. One sections reviews the Ashenden evidence.
The overall sentiment in the Salton et al. article is that the ABP is too easy to circumvent (they also explain how, e.g. by microdosing or by taking very regular doses throughout the year, but that's nothing we didn't know yet). They also point out that for the ABP to work, (very) regular testing (particularly also OOC testing) is needed. But even then, it remains relatively easy to circumvent the system.

Ow, and even if you dope with rhEPO without actively trying to circumvent the ABP, there is still only a 20% chance of getting flagged.

In addition, they note that the ABP too often leads to false positives (not often, but still too often). Interestingly, they plea for opening more ABP cases based on indirect evidence, but because of the high false-positive rate also argue that punishments should be smaller (i.e. less than two years in case of conviction).

Bottom line after reading the article:
you gotta have your head deep in the sand if you think the top-end of procycling have stopped blooddoping.
I'll read this as well when I get chance, thanks.

TourOfSardinia said:
The evolving science of detection of ‘blood doping’
Carsten Lundby, Paul Robach, Bengt Saltin
is free online here:
http://onlinelibrary.wiley.com/enhanced/doi/10.1111/j.1476-5381.2011.01822.x/
Cheers, I have institutional access which is how I got hold of the first one so I never actually realise when things are freely available (Everything should be though!) :)
 
Excellent discussion, KB. My main two posts on this article I think are #2319 and #2325 in the JV thread. I now see that I was mostly concerned with the possibility of riders on this protocol testing positive for EPO, as I think questions about that started the discussion, rather than triggering the passport. That led us into estimates of how often riders would be tested for EPO, and DW posted some data on that. Some other interesting posts in that area of the thread.

The washout point you bring up is a good one. I can’t say, but my impression is that it’s really hard to fail the passport, because the standards have to be so stringent to avoid false positives, such as from sickness, dehydration, etc. Remember Armstrong’s passport in 2009 or 2010 was very suspicious, but nothing happened (and no, that was not because he paid someone off). Even if the passport triggers the software, it still has to go to an expert panel who make the final decision. Ashenden is on record saying he has seen passports he was certain reflected doping, but he couldn't convince the other panel members.

One problem is that the software is not triggered by a decrease in HT during a GT--it treats a stable baseline then just as it would when the rider is not in competition. So if a rider can build up blood parameters gradually prior to the GT, he can have a big increase during the race (if he's concerned about being EPO positive, most of the increase can be from transfusion, with a little EPO actually helping by counteracting the suppression of retics) that will go undetected by the passport because of the compensatory tendency for the HT to decline. (In fact, you might think a rider not doping during a GT might get flagged by the software, but this apparently doesn't happen much, suggesting again that it takes a quite abnormal set of values). If he were then to stop EPO at the end of the GT, his recovering physiology would I think tend to stabilize his values.

Also check out the other link I gave you, Ashenden’s study of transfusion and the passport.
 
Aug 2, 2012
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flawed

flaw being is too many expect to find problems

..............doping was so...........last year

Mark L
 
Merckx index said:
I would like tighter parameters for an off score. Even if that means more cases are sent to review, even clean athletes, thats fine with me. the review board should be the fail safe. It sucks, because of human error and an athlete's ability to per$uade the panel, but as it is, there are too many safety valves for dirty athletes to escape through.
 
May 10, 2009
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And as good as ashenden is, it took landis talking to him for a few hours in private to fill him in on how easy it was to beat the passport and the tricks they'd use.
 

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