Petróczi Andrea, Cruyff Maarten, de Hon Olivier, Sagoe Dominic, Saugy Martial
School of Life Sciences, Pharmacy and Chemistry, Faculty of Health, Science, Social Care and Education, Kingston University, London, United Kingdom.
Department of Movement Sciences, Faculty of Movement and Rehabilitation Sciences, Katholieke Universiteit (KU) Leuven, Leuven, Belgium.
Front Sports Act Living. 2022 Dec 5;4:1017329. doi: 10.3389/fspor.2022.1017329. eCollection 2022.
High levels of admitted doping use (43.6% and 57.1%) were reported for two international sport events in 2011. Because these are frequently referenced in evaluating aspects of anti-doping, having high level of confidence in these estimates is paramount.
In this study, we present new prevalence estimates from a concurrently administered method, the Single Sample Count (SSC), and critically review the two sets of estimates in the context of other doping prevalence estimates.
The survey featuring the SSC model was completed by 1,203 athletes at the 2011 World Championships in Athletics (WCA) (65.3% of all participating athletes) and 954 athletes at the 2011 Pan-Arab Games (PAG) (28.2% of all participating athletes). At WCA, athletes completed both UQM and SSC surveys in randomised order. At PAG, athletes were randomly allocated to one of the two surveys. Doping was defined as "having knowingly violated anti-doping regulations by using a prohibited substance or method."
Estimates with the SSC model for 12-month doping prevalence were 21.2% (95% CI: 9.69-32.7) at WCA and 10.6% (95% CI: 1.76-19.4) at PAG. Estimated herbal, mineral, and/or vitamin supplements use was 8.57% (95% CI: 1.3-16.11) at PAG. Reliability of the estimates were confirmed with re-sampling method ( = 1,000, 80% of the sample). Survey non-compliance (31.90%, 95%CI: 26.28-37.52; < 0.0001) was detected in the WCA data but occurred to a lesser degree at PAG (9.85%, 95% CI: 4.01-15.69, = 0.0144 and 11.43%, 95% CI: 5.31-11.55, = 0.0196, for doping and nutritional supplement use, respectively). A large discrepancy between those previously reported from the UQM and the prevalence rate estimated by the SSC model for the same population is evident.
Caution in interpreting these estimates as bona fide prevalence rates is warranted. Critical appraisal of the obtained prevalence rates and triangulation with other sources are recommended over "the higher rate must be closer to the truth" heuristics. Non-compliance appears to be the Achilles heel of the indirect estimation models thus it should be routinely tested for and minimised. Further research into cognitive and behaviour aspects, including motivation for honesty, is needed to improve the ecological validity of the estimated prevalence rates.
据报道，2011年两项国际体育赛事中承认使用兴奋剂的比例很高（分别为43.6%和57.1%）。由于在评估反兴奋剂工作的各个方面时经常会参考这些数据，因此对这些估计值有高度的信心至关重要。
在本研究中，我们采用同步管理的单样本计数法（SSC）给出了新的流行率估计值，并在其他兴奋剂流行率估计的背景下对这两组估计值进行了严格审查。
采用SSC模型的调查由1203名参加2011年世界田径锦标赛（WCA）的运动员（占所有参赛运动员的65.3%）和954名参加2011年泛阿拉伯运动会（PAG）的运动员（占所有参赛运动员的28.2%）完成。在WCA，运动员以随机顺序完成UQM和SSC两项调查。在PAG，运动员被随机分配到两项调查中的一项。兴奋剂被定义为“故意使用违禁物质或方法违反反兴奋剂规定”。
SSC模型对12个月兴奋剂流行率的估计在WCA为21.2%（95%可信区间：9.69 - 32.7），在PAG为10.6%（95%可信区间：1.76 - 19.4）。在PAG，估计使用草药、矿物质和/或维生素补充剂的比例为8.57%（95%可信区间：1.3 - 16.11）。通过重抽样方法（ = 1,000，样本的80%）确认了估计值的可靠性。在WCA数据中检测到调查不依从情况（31.90%，95%可信区间：26.28 - 37.52； < 0.0001），但在PAG中程度较轻（兴奋剂使用为9.85%，95%可信区间：4.01 - 15.69， = 0.0144；营养补充剂使用为11.43%，95%可信区间：5.31 - 11.55， = 0.0196）。同一人群先前通过UQM报告的结果与SSC模型估计的流行率之间存在明显差异。
有必要谨慎地将这些估计值解释为真实的流行率。建议对获得的流行率进行批判性评估，并与其他来源进行三角测量，而不是采用“较高的比率一定更接近真相”的启发式方法。不依从似乎是间接估计模型的致命弱点，因此应定期进行检测并尽量减少。需要进一步研究认知和行为方面，包括诚实的动机，以提高估计流行率的生态效度。
