de Hon Olivier, Kuipers Harm, van Bottenburg Maarten
Anti-Doping Authority The Netherlands, P.O. Box 5000, 2900 EA, Capelle aan den IJssel, The Netherlands,
Sports Med. 2015 Jan;45(1):57-69. doi: 10.1007/s40279-014-0247-x.
The prevalence of doping in elite sports is relevant for all those involved in sports, particularly for evaluating anti-doping policy measures. Remarkably, few scientific articles have addressed this subject so far, and the last review dates back to 1997. As a consequence, the true prevalence of doping in elite sports is unknown. Even though it is virtually impossible to uncover the exact prevalence of a prohibited activity such as doping, various methods are available to uncover parts of this particular problem, which enables the circumvention (to a certain degree) of the issues of truthfulness, definition problems and the limits of pharmacological evidence. This review outlines the various methods that exist and presents the scarce data available in this area. It is concluded that a combination of questionnaires using the Randomised Response Technique and models of biological parameters is able to provide the statistical possibilities to reveal accurate estimates of this often undisclosed practice. Data gathered in this way yield an estimation of 14-39% of current adult elite athletes who intentionally used doping. These period prevalences have been found in specific sub-groups of elite athletes, and the available data suggest that the prevalence of doping is considerably different between sub-groups with varying types of sport, levels and nationalities. The above-mentioned figure of 14-39% is likely to be a more accurate reflection of the prevalence of intentional doping in elite sports than that provided by doping control test results (estimate of doping: 1-2% annually) or questionnaire-based research (estimations between 1 and 70% depending on sport, level and exact definitions of intent and doping). In the future, analytical science may play a more important role in this topic if it may become feasible to detect very low concentrations of prohibited substances in sewage systems downstream of major sporting events. However, it is clear that current doping control test results show a distinct underestimation of true doping prevalence. It does not seem feasible to distil better estimates of the prevalence of doping based on performance indicators or ego documents because of the various existing effects that influence athletic performance. Such information can only be used as extra information to augment the accuracy of prevalence rates that have been found by using other techniques. True doping prevalence studies have been scarce in elite sports so far. With the correct application of the available scientific methods, preferably using harmonised definitions of the terms 'doping' and 'elite sports', more information on this topic may be gathered in a relatively short time. This would assist anti-doping professionals in the future in order to evaluate the effects of possible anti-doping measures, and better anti-doping policies would serve athletes who compete without doping. The existing anti-doping measures seriously impact the lives of elite athletes and their immediate entourage, which imposes a moral burden to evaluate these measures in the best possible way.
精英体育中使用兴奋剂的流行情况与所有参与体育活动的人都相关，尤其对于评估反兴奋剂政策措施而言。值得注意的是，到目前为止，很少有科学文章探讨这个主题，上次综述可追溯到1997年。因此，精英体育中使用兴奋剂的真实流行情况尚不清楚。尽管几乎不可能揭示诸如使用兴奋剂这种违禁活动的确切流行率，但有各种方法可用于揭示这一特殊问题的部分情况，这能在一定程度上规避真实性、定义问题和药理学证据局限性等问题。本综述概述了现有的各种方法，并展示了该领域现有的稀缺数据。得出的结论是，结合使用随机应答技术的问卷和生物参数模型能够提供统计可能性，以揭示对这种往往未公开的行为的准确估计。以这种方式收集的数据显示，目前有14% - 39%的成年精英运动员故意使用过兴奋剂。这些时期流行率是在精英运动员的特定亚组中发现的，现有数据表明，不同运动类型、水平和国籍的亚组之间，使用兴奋剂的流行率有很大差异。上述14% - 39%的数字可能比兴奋剂检测结果（每年兴奋剂使用估计为1% - 2%）或基于问卷的研究（根据运动、水平以及意图和兴奋剂的确切定义，估计在1%至70%之间）更准确地反映精英体育中故意使用兴奋剂的流行率。如果在重大体育赛事下游的污水系统中检测到极低浓度的违禁物质变得可行，那么分析科学在未来可能会在这个主题中发挥更重要的作用。然而，很明显，目前的兴奋剂检测结果明显低估了真实的兴奋剂使用流行率。基于表现指标或自我文件来提炼对兴奋剂使用流行率的更好估计似乎并不可行，因为存在各种影响运动表现的因素。此类信息只能用作额外信息，以提高通过其他技术得出的流行率的准确性。到目前为止，精英体育中真正的兴奋剂使用流行率研究一直很少。通过正确应用现有的科学方法，最好使用对“兴奋剂”和“精英体育”术语的统一界定，可能会在相对较短的时间内收集到关于这个主题的更多信息。这将有助于未来的反兴奋剂专业人员评估可能的反兴奋剂措施的效果，更好的反兴奋剂政策将有利于那些不使用兴奋剂参赛的运动员。现有的反兴奋剂措施严重影响着精英运动员及其直接随行人员的生活，这给以尽可能最佳方式评估这些措施带来了道德负担。
