EPO of no effect in bike races, claim researchers who staged Mont Ventoux race

Tommytazzer wrote:

Blimey - there's a lot of scientific illiteracy in this thread. Let's break this down

• Epo takes weeks to work so of course they wouldn't have just injected it at the start of the ride. 
• Randomised placebo controlled blinded trials like this one are the gold standard study for stuff like this. The (very powerful) placebo effect is controlled for because no one knows if they're getting epo or saline injections. Nor would the scientists administrative  the drug or those recording the result. Bias is therefore minimised. 
• This sort of study is the only way you can answer the question - does erythropoietin improve cyclist performance? Just because it should work doesn't mean it actually does (there are countless drugs in the medical world that should work but don't. 
• The plural of anecdote is not data. Just because you heard that your neighbours brother in law increased his threshold power by 70 watts after starting epo means diddly-squat. 
• Finally - the trial hasn't been published yet. To know whether this study is up to snuff I'd have to read the detailed methodology and look hard at the statistical methods used. 

The use of Ventoux invalidates the whole experiment.

No two ascents will ever be exactly the same so the results will not be reproducible.

They also fail to address the role that the Athlete themselves plays.

Put me in a slightly faster car than Lewis Hamilton and he'll still beat me round an F1 track because he is so much better at driving.

Give a pro 40 more watts and they'll squeeze every ounce of benefit from it. Give me 40 more watts and I'll probably set off too fast, go into the red and blow up halfway up the hill.

Climbing successfully is not all about power to weight, there is a considerable amount of skill involved (notwithstanding variables such as weather, traffic, mechanicals etc) unless they found a way to control for that then the results are worthless.

Stick them on turbo trainers and measure their FTP pre and post EPO. That would be scientific.

[/quote] The use of Ventoux invalidates the whole experiment. No two ascents will ever be exactly the same so the results will not be reproducible. They also fail to address the role that the Athlete themselves plays. Put me in a slightly faster car than Lewis Hamilton and he'll still beat me round an F1 track because he is so much better at driving. Give a pro 40 more watts and they'll squeeze every ounce of benefit from it. Give me 40 more watts and I'll probably set off too fast, go into the red and blow up halfway up the hill. Climbing successfully is not all about power to weight, there is a considerable amount of skill involved (notwithstanding variables such as weather, traffic, mechanicals etc) unless they found a way to control for that then the results are worthless. Stick them on turbo trainers and measure their FTP pre and post EPO. That would be scientific.[/quote]

But the control and intervention group all climbed the same mountain right? As I said I'd have to read the paper, but that doesn't invalidate it. 

Tommytazzer wrote:

But the control and intervention group all climbed the same mountain right? As I said I'd have to read the paper, but that doesn't invalidate it. 

Unless you can guarantee that the conditions on the mountain were identical for every rider then it does invalidate the results.

Conditions at that altitude can change so quickly that even a 15 minute difference in start times can completely alter the nature of your ride.

We know EPO (when correctly dosed) increases red blood cell production (it is medically licensed for this purpose).

We know red blood cells carry oxygen.

We know muscles use oxygen when doing work.

It stands to reason that (correctly dosed) EPO would therefore increase your aerobic capacity and your anaerobic threshold/ functional threshold power.

If you really wanted to test that theory you'd just need to do reproducible indoor threshold testing on the two groups.

Even if the EPO group did increase their thresholds they may not have been able to utilise that in a real world climb due to their lack of experience.

An elite pro on the other hand would make the most of every extra watt.

Rich_cb wrote:

Tommytazzer wrote:

But the control and intervention group all climbed the same mountain right? As I said I'd have to read the paper, but that doesn't invalidate it. 

Unless you can guarantee that the conditions on the mountain were identical for every rider then it does invalidate the results. Conditions at that altitude can change so quickly that even a 15 minute difference in start times can completely alter the nature of your ride. We know EPO (when correctly dosed) increases red blood cell production (it is medically licensed for this purpose). We know red blood cells carry oxygen. We know muscles use oxygen when doing work. It stands to reason that (correctly dosed) EPO would therefore increase your aerobic capacity and your anaerobic threshold/ functional threshold power. If you really wanted to test that theory you'd just need to do reproducible indoor threshold testing on the two groups. Even if the EPO group did increase their thresholds they may not have been able to utilise that in a real world climb due to their lack of experience. An elite pro on the other hand would make the most of every extra watt.

nothing "stands to reason" in physiology and medicine. Everything needs testing. An organism is so much more complicated than you seem to think - just because oxygen carrying capacity is increased doesn't mean performance necessarily also increases. Maybe the increased haematocrit cause micro obstructions in the capillary bed leading to areas of hypoperfusion. Or maybe some other unforeseen effect occurs. The point is we don't really know until we do the study. And the outcome of the study should be the thing were interested in - in this case how much faster does epo make a cyclist go up a hill. So time the subjects going up hills. Measuring their power on a watt bike is a surrogate marker of epo's efficacy. 

Tommytazzer wrote:

nothing "stands to reason" in physiology and medicine. Everything needs testing. An organism is so much more complicated than you seem to think - just because oxygen carrying capacity is increased doesn't mean performance necessarily also increases. Maybe the increased haematocrit cause micro obstructions in the capillary bed leading to areas of hypoperfusion. Or maybe some other unforeseen effect occurs. The point is we don't really know until we do the study. And the outcome of the study should be the thing were interested in - in this case how much faster does epo make a cyclist go up a hill. So time the subjects going up hills. Measuring their power on a watt bike is a surrogate marker of epo's efficacy. 

I agree with the need to test whether increasing your haemoglobin does increase your FTP but it needs to be done in a controlled environment.

Ventoux has so many variables (that can't even be easily measured) that doing the experiment there makes it essentially worthless.

Surely you must have cycled up a hill in a headwind before? How different was it to a still day? Or a day with a tailwind? What about a very hot or very cold day?

These things affect performance so much that a gap of a few seconds between two groups becomes meaningless.

Power in a static bike is not a surrogate marker, it's a reliable, reproducible figure. You can even reproduce the effects of altitude.

Rich_cb wrote:

Tommytazzer wrote:

 

nothing "stands to reason" in physiology and medicine. Everything needs testing. An organism is so much more complicated than you seem to think - just because oxygen carrying capacity is increased doesn't mean performance necessarily also increases. Maybe the increased haematocrit cause micro obstructions in the capillary bed leading to areas of hypoperfusion. Or maybe some other unforeseen effect occurs. The point is we don't really know until we do the study. And the outcome of the study should be the thing were interested in - in this case how much faster does epo make a cyclist go up a hill. So time the subjects going up hills. Measuring their power on a watt bike is a surrogate marker of epo's efficacy. 

I agree with the need to test whether increasing your haemoglobin does increase your FTP but it needs to be done in a controlled environment. Ventoux has so many variables (that can't even be easily measured) that doing the experiment there makes it essentially worthless. Surely you must have cycled up a hill in a headwind before? How different was it to a still day? Or a day with a tailwind? What about a very hot or very cold day? These things affect performance so much that a gap of a few seconds between two groups becomes meaningless. Power in a static bike is not a surrogate marker, it's a reliable, reproducible figure. You can even reproduce the effects of altitude.

I very much doubt the study design separated the control group from the epo group and made them ride up Ventoux separately. That would be almost comically inept design. Almost certainly they were sent up the hill in a random order and that randomness is what makes the test more valid. Obviously you'd have to get the number of participants right or the trial would be underpowered but there are various statistical methods to ensure that. 

Tommytazzer wrote:

I very much doubt the study design separated the control group from the epo group and made them ride up Ventoux separately. That would be almost comically inept design. Almost certainly they were sent up the hill in a random order and that randomness is what makes the test more valid. Obviously you'd have to get the number of participants right or the trial would be underpowered but there are various statistical methods to ensure that. 

It states in the article that "The riders... had already ridden 120km before tackling Mont Ventoux during the weekend’s race."

So they would not arrive at the mountain in any pre determined order or at the same time.

They would also already have had 120km or variable conditions prior to starting the climb.

This makes the results meaningless.

A basic requirement of study design is that the results should be reproducible.

This study fails in that regard.

Tommytazzer wrote:

Blimey - there's a lot of scientific illiteracy in this thread. Let's break this down

• Epo takes weeks to work so of course they wouldn't have just injected it at the start of the ride. 
• Randomised placebo controlled blinded trials like this one are the gold standard study for stuff like this. The (very powerful) placebo effect is controlled for because no one knows if they're getting epo or saline injections. Nor would the scientists administrative  the drug or those recording the result. Bias is therefore minimised. 
• This sort of study is the only way you can answer the question - does erythropoietin improve cyclist performance? Just because it should work doesn't mean it actually does (there are countless drugs in the medical world that should work but don't. 
• The plural of anecdote is not data. Saying that you heard that your neighbours brother in law increased his threshold power by 70 watts after starting epo means very little. What about all the doping cyclists who's power didn't increase. You have no idea how many of them there are. That's what trials are for. 
• Finally - the trial hasn't been published yet. To know whether this study is up to snuff I'd have to read the detailed methodology and look hard at the statistical methods used. 

I think that you're right for the most part. But either the reporting above is very bad (plausible) and/or the experiment set up is not very scientific. Why would you use a mountain when an indoor trainer can reveal the results so much more effectively? Thereby removing the variables that cycling up a windy mountain at different times while on holiday might have.....

Tommytazzer wrote:

• The plural of anecdote is not data.

The correct quote is "The plural of anecdote is data."

Sure, just your neighbours brother in law increasing their threshold power by 70 watts is an anecdote but if my neighbours brother in law did the same, woah, that's data right there. 

risb98 wrote:

This study design is what is called a  double blind placebo controlled study. The numbers of riders may not have the power to provide statistical significance, but if designed propely, it will. Done properly this is exactly the type of study to asnwer the question they are asking. you would have to control for confounding factors such as intensity of training, but otherwise the methodology looks sound, the riders may have been paired or randomly assigned to each group. Wait for the paper to be published, not ethe quality of the journal, and then make your judgement, not before

The methodology for their experiment does look sound, as far as all the statistical and experimetnal design basis goes. The problem is that the very idea of their test is stupid, that simply isn't how EPO works! It is not a one-shot, instant-action chemical.

risb98 wrote:

This study design is what is called a  double blind placebo controlled study. The numbers of riders may not have the power to provide statistical significance, but if designed propely, it will. Done properly this is exactly the type of study to asnwer the question they are asking. you would have to control for confounding factors such as intensity of training, but otherwise the methodology looks sound, the riders may have been paired or randomly assigned to each group. Wait for the paper to be published, not ethe quality of the journal, and then make your judgement, not before

I agree. I have a feeling that there is only half a story here. It seems unclear on how the results were evaluated. Average speed between the two groups would seem odd as the variance between the two groups could be larger than the benefit however if you assume that they are a similar bunch then this variance is reduced by taking average speed.
In addition it seems they wanted to evaluate effect on racing rather than individual effort so I guess this was a bunch race to the top. After all the effects of epo on an individual system have been reviewed a number of times before but not the actual effect on a race situation.
From the article it's difficult to understand what conclusions can be drawn apart. Just Remember drugs don't work and no one has been kicked off a race for taking a placebo.

Colin Peyresourde wrote:

Jesus wept. Some people need to re-read this article again. They dosed them for weeks in advance, so they didn't just turn up, jab them and told them to ride.

Indeed; this comments thread reads like an advert for reading comprehension classes.