Dear Peri, you mention a very important and interesting question.

To my opinion, we have to differentiate between elite and recreational athletes/sports. If in professional sports the analytical system fails, as it seems like if we compare the data of analytical tests with indipendent surveys, is there any chance to win the doping fight against the professional sports system. And what does "winning" mean in this context? To have a 100% clean professional sports system. I think that freezing and re-open the analytical test after eight years was a big step into the right direction. But detecting athletes as analytically positives after eight years is also not satisfying.

In recreational athletes or hobby sports, I think we should intensify using the Internet as a virtual and modern platform for distributing prevention and education concepts, especially in young athletes. First projects using the platform YouTube have already been performed. The developement and evaluation of such Internet based concepts is to my opinion a large knowledge gap which may provide new persepctives for research. 

Best,

Pavel

Regarding the retrograde testing I wonder:

If we researchers struggle for 6 years to get approval for submitting a manuscript to a scientific Journal, how complicated could it be to get permission to re-analyse Doping samples in a meaningful, Independent, non-biased way? I bet the sports authorities are sitting in and on the fridges.Would be really nice to know.

Dear Perikles,

thank you and your colleagues for conducting this study and I am glad that you were able to get it published - after all. Thanks for your persistence!

There are certainly several conclusions to draw from your findings. But from a scientific viewpoint, in my opinion the next step should be an attempt to explain the huge discrepancy between prevalences from biological testing and reported prevalence in your study. Therefore, one approach could be to get current information about the substances used - potentially with your randomised-response technique. I am very impressed by the high response rate you got. It shows the demand - maybe even a desire - of athletes to talk about this topic. That's something that could be done before going the long-way and try to get and re-analyse the samples independently.

However, I do understand your reasonable doubts. There are many interests in this game, but I think we (sport scientist / sport physicians) owe it to the clean athletes to bring this doping debate on an elaborated scientific foundation and public discussion.

Dear Karsten,

Yes, both, response rate and willingness to admit doping were impressive.

I share your notion that athletes seem to be more willing to report about doping, if it was completely anonymous. However, there comes a severe weakness of the RRT-techniques. There is only a few options that allow for assessment of a reasonable amount of information (->your suggestion to go into details with doping).

I am afraid, we may need to switch techniques, but I doubt that an anonymous questionnaire could do the trick.

@Karsten,

as far as the willingness to go on and try to improve the situation is concerned...

Intriguingly, our research on RRT and doping or CE prevalence has never received significant funding. This is all use of public money to do something which is then tried to be kept under the carpet by sports federations and authorities.

Personally, I think that we have to reconsider our work and willingness to cooperate with the "sports system". They want first and foremost "the perceived level playing field".

If you are going to challenge that there is something like a "level playing field" - you are out!

Then you can start to go and do research at the "Bundesjugendspiele". (-:

Dear Perikles,

personally,  I really liked the "Bundesjugendspiele" when I was younger - but of course I get your point. Somehow it is counter-intuitive that there is almost no (independent) funding for this research area. Detecting and preventing doping should be a promising and valid approach to increase fairness and of course the chances of success of clean athletes. In my opinion, this should be of interest also for national funding agencies like our BISP. Maybe your study helps to sensitise these and other stakeholders but I understand your frustration. Maybe another option could be to work out of different university chairs on this topic - that's probably an option that provides sufficient independence. 

Dear Karsten,

interestingly, the level of independence and transparency of the different instances that combat doping is organized very differently from country to country. There seem to be countries that do better than Germany. 

Any best practice guidelines are welcome. I know the USADA, conflict of interest guidelines. I wonder wether the German NADA startet to write some, already? I recommended to do so 8 years ago and 2 years ago they were still missing. 

I will definitely pick up your suggestion to look for a mutual agreement amongst some other chairs in sports medicine on how to proceed. 

May be it is the athletes that need to fight "just a bit more" for their personal rights and their health?

And may be we scientists involved in organized sports will also need to fight for more independent and high quality science and respective medical support of athletes?