OK, this may seem really lateral, but bear with me. Here’s a solid study showing that an intensive education intervention in 9-10 year olds does not help prevent obesity & overweight: thelancet.com/journals/lanch… This made me think about anti-doping education, so here’s a short thread “Education” is often held up as a powerful and effective tool for anti-doping, despite pretty thin evidence that it does anything. If I’m cynical, an over-reliance on education seems to often replace the obligation to test as the thought of most effective deterrent.

The IAAF’s research on testosterone & performance has significant data errors & problems. We (@RogerPielkeJr, @boyeerik & I) have reanalysed some of the events, finding errors that may affect its conclusions and so call for it to be retracted. Story here: nytimes.com/2018/07/12/spo… To elaborate briefly - in early May, we wrote to BJSM to request the performance data used by the IAAF in the study. This after noticing some strange statistical implications of their reported results, and wondering about methods to exclude duplicates: blogs.bmj.com/bjsm/2018/05/1…

So…#russia have run the furthest of any team at this year’s #WorldCup18 triggering the inevitable discussion about the suspicion that would already have existed, given many suspicions. I wanted to share a few thoughts on this, so here’s a short thread... First, whether or not there is doping in football is an unnecessary question. I don’t even understand why people discuss this as a “are they, aren’t they question”. This is as true of Russia as pretty much every team.

Every time a footballer collapses in agony, and forces the game to be stopped, there should be a mandatory 5 min assessment period. The game goes on, no temporary substitution. Make sure that poor diddums is OK, and disincentivize the behavior that characterizes football. I applaud many of you for realizing the possibility of second order consequences on this. I’d expect nothing less. Thanks for those who have raised them. I had (believe it or not) thought through these possible downsides, and I don’t believe they are insurmountable challenges.

This is, for many reasons, a fascinating story. It’s the trigger for discussions ranging from medical/duty of care failure to legal/policy issues. According to US doctors, #Karius is #concussed in this incident, shortly before the 1st of his huge errors. Brief thoughts follow... First, a too-common reaction is “What a lame excuse, he’s clearly not concussed”, because it doesn’t look like they expect it to. And, hey, you all know I value sound skepticism! But the thing about concussion is that only about 50% of them show present with any of these signs:

Next time a voice in your head says “But he/she hasn’t tested positive. Show me evidence”, remember Jama Aden - IAAF followed & observed his group for 30 months, then a hotel raid discovered syringes with EPO & anabolic steroids. Not one of his athletes failed a test in that time Now Aden is facing 4.5 years in jail for providing 8 types of substances to his athletes, from EPO to corticoids: cat.elpais.com/cat/2018/06/01…

So even a 30 month spotlight, a raid, & focused testing caught 0%. So yeah, you can have your “never failed a test”. I’ll take sense.

In case you missed it - here’s my thread with some thoughts on the “Futility of urine salbutamol” paper that may form part of Sky’s intent to criticize the validity of the test. Also, one or two additional updates and thoughts below it.

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I was re-reading the paper last night, & this section from its discussion really jumps out. It reads like a closing argument of a lawyer in a John Grisham novel. Given that the findings come from simulations using a “semi physiological” model based on dogs, it’s a little strong

Right…there’s a study called “Futility of current urine salbutamol doping control” that is receiving some press today. It’s clearly related to the #Froome #salbutamol defense. I have some thoughts, and I’ll try to be brief, but apologies if this thread gets lengthy… (1/) First, here’s a link to the study: bpspubs.onlinelibrary.wiley.com/doi/abs/10.111…

What they did is develop a pharmacokinetic model for salbutamol, and then ran 1000 simulations where a VIRTUAL subject inhales a dose of 800 mcg. The model then PREDICTS the urine concentration in those 1000 cases

I have one or two thoughts on the IAAF hyperandrogenism guidelines, which I will share briefly, and then try to find time for more detail soon. First, here’s an interesting part of the IAAF statement. They estimate a 9% performance advantage IF an individual is sensitive to T This is important because remember when the IAAF did a study comparing women with lower T to higher T? They found a 2-4% advantage in certain events only. So this 9% is “theoretical”, & requires sensitivity to T (that’s how they’d explain the absence of advantage in their study)

So I’ve been thinking about this heatstroke and hot marathon issue, anticipating London. I want to just illustrate a point about heatstroke. Take a look at this - body temp of a runner at 2 Oceans (56km) a few years ago. It was 24C at the time this guy collapsed with 1km to go He had a temp of 41.8C, and was immersed (torso & pelvis) in an ice-water bath (about 5C), with a giant fan on him. After 45 min, his temperature had dropped, but was still 40.1C. Sitting in a bath of ice water! He then went to hospital where more cooling with ice-packs was done