Is how many members of the peloton are doping with testosterone? Myself, I would guess very few as this is a substance which everyone knows can be easily tested for right. Suppose we construct a hypothetical peloton of 100 riders and say 1 is doping with testosterone.
The next question is how good is the testosterone test in terms of sensitivity (the ability to detect a true positive) and specificity (the ability to detect a true negative). Lets hypothetically say its a kick ass test with a 99% sensitivity and a 99% specificity. These numbers would make it logs more sensitive and specific than most routinely used medical diagnositic tests such as PSA, mammography, colonoscopy, etc. To sum up this test is so good that if you test positive there is a 99% chance you are doping and if you test negative there is a 99% chance you are truly clean. Wow, what a great test, sign me up, we are going to stomp out this cheating crap with this test.
So what happens if you apply this test to our hypothetical peloton. Well the poor chap who is doping with testosterone is going to get pinched with 99% certainty. But it turns out that if you then test all 99 other riders who are clean you are equally likely to turn up 1 false positive. So Dick Pound now has 2 individuals with positive tests sitting in front of him from our peloton. One is a doper and one is not. The positive predictive value (or PPV) for this test in this population is only 50%!!
Note this is only a hypothetical example and I have no idea whether Floyd is guilty or not. It just points up the epidemiological hardships associated with drug testing (and testing with anything else in medicine). This is why we generally try to employ 2 separate and independent methods to confirm most medical diagnoses (i.e. an MRI scan and a biopsy, a blood and urine test, ELISA and Western Blot) and even then we still encounter situations routinely where answers are confusing, don’t add up, or later turn out to be wrong.
A testoserone patch applied directly to the scrotum purportedly works within hours and is unlikely to be detected (ratio of 4 x 1 vs. natural ratio of 1 x 1; easy to boost somewhat without reaching 4 x 1).
the real questions is where does one get the patch? Can any doctor prescribe one? Just a questions…I am a firm believer in doing things the hard way. (which means training hard and not being very fast)
Yes, you can dope with testosterone any number of ways quite easily. That misses the point that the value of a test lies within its positive predictive value (PPV) which is mathematically determined by the inherent sensitivity/specificity of the test itself as well as the incidence of the item being tested in the study population. If you think that the incidence of testosterone use in the peloton is high then almost certainly Floyd is guilty (but then more people should test positive if the test is any good), but if the incidence of testosterone use in the peloton is low then even with a very good test, the frequency of a false positive will rise.
Let’s pretend that Floyd needed some help recovering, and decided to apply the patch to the scrot. He would clearly know this would elevate his levels. Why wouldn’t he wait until the next day, or later that night, and inject or patch some additional Epitestosterone so that the ratio would stay closer to 1:1. Dodging a doping test for testorone based on ratios means that the test can be, (and has been) succesfully circumvented, and it seems weird to me that he would take the neccesary cover-up measures if he really was doping.
If I follow you right, then if Floyd did not dope, and his A sample was a false positive, then there would be 99% certainty that his B sample would be negative, right?
ESPN’s coverage suggested the problem for Floyd was not abnormally high testosterone levels, but an abnormally high testoterone-to-epitestosterone level, caused by abnormally low levels of the latter hormone. Not sure this is verifiable…
Another point is that a quick boost of testosterone shouldn’t have any immediate performance benefits. My understanding is that the heightened testosterone enhances training effects, like steroids.
IF this test is based on the ratio of testosterone to epitosterone why would the rules even try to say that a normal testosterone level is ok, but with the lower epitestosterone it isnt? It just seems ridiculous to think that he would be in trouble for basically a low epitestosterone to testosterone level. I dont see how that can help your performance.
Just thought about it again and i guess it could be a negative feedback axis. If i rememebr anat and phys correctly it could be with the lower the epi testosterone the higher the testosterone release? Could someone set this thinking straight?
No, not necessarily. False positives are caused both by test error as well as physiologic alterations in the individual under question. It is entirely possible that the measured ratio is correct but the test still represents a false positive for the test condition that Floyd is doping. As an example from medicine. The beta-HCG test is an extremely reliable, sensitive, and specific test for pregnancy. Almost fool proof. Yet in my practice every year I see 1 or 2 men with positive beta-HCG tests. We can run it over and over again and it will still be positive. Are they pregnant? No, it is a false positive. They have choriocarcinoma. The type of cancer Lance had. The problem is that drug testing as currently employed by WADA tries to use a single drug test as diagnostic for cheating. Mathematically this is hard to justify from an epidemiological standpoint no matter how good the tests are. As you test more and more people in your population who are negative, you will eventually get false positives. As far as I can tell, WADA doesn’t grasp this basic fact. The Rutger Beke case should be an excellent example.
I think the real question is how many hairs does that patch pull off your scrotum. That’s gotta hurt.
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If you shave your balls you’ll be fine. However, what surprises me is that the investigators are not looking for an elongated sack. When I pull off my scrot patch every morning, the force required to break the sticky bond results in my balls hanging .13 cm lower with each use. Since I am a regular user, my nuts regularly slap against the inside of my knee. Screw the “chromatograph/combustion/isotope ratio mass spectrometer” test - just looking for the low hanging nards.