WADA study supposedly says those with TUE aren't more likely to win an Olympic medal? Is this really true?

Summary here:

https://www.wada-ama.org/en/media/news/2020-05/wada-study-reveals-no-meaningful-link-between-tues-and-the-likelihood-of-winning

The data you really need (and that isn’t given) is whether an individual athlete with a TUE is more likely to win a medal than they would without that TUE. I think that the answer would clearly be yes.

I disagree. TUEs are approved for people with health conditions that require restricted/banned therapies. In general I would suspect healthy people (no requirement for TUE) are more likely to win medals than sick people (might need TUE).

LoneStarXC wrote:

The data you really need (and that isn’t given) is whether an individual athlete with a TUE is more likely to win a medal than they would without that TUE. I think that the answer would clearly be yes.

Vancomycin wrote:

I disagree. TUEs are approved for people with health conditions that require restricted/banned therapies. In general I would suspect healthy people (no requirement for TUE) are more likely to win medals than sick people (might need TUE).

LoneStarXC wrote:

The data you really need (and that isn’t given) is whether an individual athlete with a TUE is more likely to win a medal than they would without that TUE. I think that the answer would clearly be yes.

This is the idea behind TUES and why they’re a thing, but the problem is when bogus TUES get handed out. See, for example:

To be fair, the Fancy Bears leak showed that the TUE system was, in general, being used correctly.

There were a couple of dodgy ones, but the vast majority were innocuous and explainable.

Are they just checking during the competition period or overall who takes TUES

The WADA summary report indicates

Entrants: 20,139 total - 181 have TUEs and 19,958 without.

The medalists: 2062 total - 21 have TUEs and 2,041 without.

The percent winning medals:

with TUEs = 11.6%

without TUEs = 10.2%

The TUE advantage = (.116-.102)/.102 = .135 = 13.5%

Check this out:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4933613/

If you click on figure 1, you can see that asthmatic athletes are over represented on the medal podium. For example, in Vancouver 2010, 7.1% of athletes in attendance were diagnosed with asthma, but 11.8% of medals were won by asthmatics. This difference is less pronounced in summer Olympics, such as Athens 2004

when 4.2% of total athletes in attendance had asthma, but won 5.4% of the medals, BUT, as the article says, this is because a greater proportion of summer sports (compared to winter sports) are “sedentary” (e.g. shooting, archery, etc.), and...

Interesting. So there is a greater prevalence of asthmatic athletes in sports where the use of B2-agonists (e.g. salbutamol, terbutaline) and glucocorticoids would confer an advantage. That can’t be a coincidence.

Tue doesn't do what people think it does. At least not if it's giving in normal levels. Even when in giving in higher levels there are too many adverse side effects to even make it worth it and any self respecting doctor wouldn't do. There are far better drugs out there for performance enhancement.

This is an issue with some first World athletes in particular, but the real issue is with prohibited and gray zone doping.

LoneStarXC wrote:

This is the idea behind TUES and why they’re a thing, but the problem is when bogus TUES get handed out. See, for example: (Lauren Fleshmen)

Lonestar -- I think part of the confusion is that TUEs are not the same as prescription drug abuse.

If you look at the case of Lauren Fleshman, she was eventually prescribed Advair (Salmetoral + Fluticasone) and albuterol (Salbutomal).

Both of these are allowed by the WADA prohibited list, and do not require TUEs.

Some B2-agonists are allowed when inhaled within limits, and glucocorticoids are allowed out of competition.

We need another catchy acronym or name to describe the WADA legal medicalization of sport.

gimme drugs!!

+1

I wonder if the best use of WADA funds are to dispel myths surrounding something that is not an issue when the WADA guidelines are adhered to and enforced, which appears to be the case across five Olympics.

Quotes from WADA's summary:

More quotes from another publication "The World Anti-Doping Code: can you have asthma and still be an elite athlete?":

Under these conditions, the study results are unsurprising:

1) The actual number of TUEs granted in the athlete population is low (less than 1%), as are the medals won (21 out of 2061, or 1% over 5 Olympics)

2) On the balance of probabiliities, the drug is unlikely to provide performance enhancement beyond what is normal, according to four layers of checks: the athlete, the TUEC, the ADO, and WADA.

Bthestat wrote:

The WADA summary report indicates

Entrants: 20,139 total - 181 have TUEs and 19,958 without.

The medalists: 2062 total - 21 have TUEs and 2,041 without.

The percent winning medals:

with TUEs = 11.6%

without TUEs = 10.2%

The TUE advantage = (.116-.102)/.102 = .135 = 13.5%

What kind of crazy math is that?

The percentage winning medals with a TUE is 21/2062 = 1.02%

The percentage winning medal without a TUE is 2041/2062 = 98.99%

The percentages "Bthestat" posted were in response to Lonestar's post "whether an individual athlete with a TUE is more likely to win a medal than they would without that TUE.":

Among the TUE athletes, what percentage won medals. 21/181 = 11.6%

Among the non-TUE athletes, what percentage won medals. 2041/19958 - 10.2%

The other logical conclusion would be that endurance training causes asthma/AHR, whether from exposure to pollutants, cold air, or something else.

Did it specify if they were on a TUE at the competition or had ever been on a TUE? The number on a TUE seems low unless it was only looking at in competition TUE usage.

My understanding is the science savvy can abuse the TUE process for performance enhancing benefits in training which can carry into racing.

The study looked at TUEs in the ADAMs database, which should include all TUEs, regardless of competitions.TUEs aren't tied to a competition. For inhalers, for example, a TUE is valid for 4 years,

If it seems like the number of TUEs are low, perhaps it's because it is what it seems to be. The point of the study is to show with objective data, that TUEs are not all that common, and it is not the performance enhancing doping loophole that so many seem to believe it is. Part of what might fuel that belief is another mistaken belief that certain inhalers, as well as other medicines like thyroid medication require a TUE.

If WADA guidelines are respected, TUEs are not likely to be performance enhancing beyond restoring what would be a normal level of performance, as that is one of the explicit criteria to grant a TUE. In other words, if it could be performance enhancing, the TUE would not meet the criteria to be granted.

Bthestat wrote:

The WADA summary report indicates

Entrants: 20,139 total - 181 have TUEs and 19,958 without.

The medalists: 2062 total - 21 have TUEs and 2,041 without.

The percent winning medals:

with TUEs = 11.6%

without TUEs = 10.2%

The TUE advantage = (.116-.102)/.102 = .135 = 13.5%

That's garbage. You didn't include the confidence level with doing that.

The percent winning medals (95% confidence level) is:

with TUEs = 6.9 %-16.3%

without TUEs = 9.8%-10.6%

There is no difference. The WADA summary report already provided the risk ratio and confidence intervals.