Back to the game: how Congress can help sports leagues shift the focus from steroids to sports

J Contemp Health Law Policy. 2007 Spring;23(2):341-63
Saka JM.
PMID: 17642385

Back to the game: how Congress can help sports leagues shift the focus from steroids to sports

Bayesian detection of abnormal values in longitudinal biomarkers with an application to T/E ratio

Biostatistics. 2007 Apr;8(2):285-96\. ePub 19 June 2006
Sottas PE, Baume N, Saudan C, Schweizer C, Kamber M, Saugy M.
Swiss Laboratory for Doping Analyses, Universite de Lausanne, Chemin des Croisettes 22, Lausanne, Switzerland
PubMed ID & Record: 16785250

We developed a test that compares sequential measurements of a biomarker against previous readings performed on the same individual. A probability mass function expresses prior information on interindividual variations of intraindividual parameters. Then, the model progressively integrates new readings to more accurately quantify the characteristics of the individual. This Bayesian framework generalizes the two main approaches currently used in forensic toxicology for the detection of abnormal values of a biomarker. The specificity is independent of the number n of previous test results, with a model that gradually evolves from population-derived limits when n = 0 to individual-based cutoff thresholds when n is large. We applied this model to detect abnormal values in an athlete's steroid profile characterized by the testosterone over epitestosterone (T/E) marker. A cross-validation procedure was used for the estimation of prior densities as well as model validation. The heightened sensitivity/specificity relation obtained on a large data set shows that longitudinal monitoring of an athlete's steroid profile may be used efficiently to detect the abuse of testosterone and its precursors in sports. Mild assumptions make the model interesting for other areas of forensic toxicology.

Doping, drugs and drug abuse among adolescents in the State of Thuringia (Germany): prevalence, knowledge and attitudes

Int J Sports Med. 2007 Apr;28(4):346-353 Epub 2006 Oct 6
Wanjek B, Rosendahl J, Strauss B, Gabriel HH.
Department of Sports Medicine, Friedrich-Schiller-University, Jena, Germany.
PubMed ID & Record: 17024651

Goal-directed measures to prevent doping and drug abuse in sports requires empirical data. In this connection, a cross-sectional analysis was carried out in 2004\. The purpose of the study, on the one hand, was to register reliable data of the current situation in Thuringia, and, on the other hand it was to give information on possible interventional steps with scientific support. Within three months, 2319 adolescents from 16 Thuringian schools (5 regular schools, 4 secondary schools, 3 sport schools and 4 vocational schools) were surveyed. Three hundred and forty-six (15.1 %) students out of 2287 students (26 students without a statement) indicated use of prohibited substances from the WADA list in the previous year: 16 (0.7 %) anabolic-androgenic steroids (AAS), 10 (0.4 %) growth hormones, 56 (2.4 %) stimulants, 305 (13.2 %) cannabis, 2 (0.1 %) diuretics, 52 (2.2 %) cocaine/heroin and 6 (0.3 %) erythropoeitin. Moreover, nonathletes (N = 490) reported a substance use that was approximately 5.0 % higher than that of recreational athletes (N = 1254) and nearly three times higher than that of competitive athletes (497). All three groups (nonathletes, recreational athletes and competitive athletes) performed poorly on a knowledge test regarding doping in general with an average below 60 % in each case. Another main aspect of the study was to determine factors influencing substance use in sports. Besides the doping specific knowledge (beta = 0.06, p < 0.05), age contributed (beta = 0.09, p < 0.05), as well as anti-doping attitude (beta = -0.34, p < 0.05), to the resulting variance. Gender, however, played no role. The findings of the study point towards the need for improvement of specific knowledge of doping among students and that their attitude towards doping must be altered. The goal in this case is to test the effectiveness of appropriate scientific intervention.

Ethics in sports medicine

Am J Sports Med. 2007 May;35(5):840-844 Epub 2007 Jan 11
Dunn WR, George MS, Churchill L, Spindler KP.
Vanderbilt Sports Medicine Center, Nashville, Tennessee, USA.
PubMed ID & Record: 17218662

Physicians have struggled with the medical ramifications of athletic competition since ancient Greece, where rational medicine and organized athletics originated\. Historically, the relationship between sport and medicine was adversarial because of conflicts between health and sport\. However, modern sports medicine has emerged with the goal of improving performance and preventing injury, and the concept of the "team physician" has become an integral part of athletic culture\. With this distinction come unique ethical challenges because the customary ethical norms for most forms of clinical practice, such as confidentiality and patient autonomy, cannot be translated easily into sports medicine\. The particular areas of medical ethics that present unique challenges in sports medicine are informed consent, third parties, advertising, confidentiality, drug use, and innovative technology\. Unfortunately, there is no widely accepted code of sports medicine ethics that adequately addresses these issues.