ACE's PURE Sport program is a comprehensive anti-doping program that tests for three categories of abuse -
blood doping, anabolic steroid use and hormone use, such as HGH. The program is unlike any other anti-doping program in both
scope and nature. ACE's PURE Sport program involves year round testing of every athlete - each rider will be subject to a
minimum of 26 collections of blood, serum and urine yearly. Testing is random and ACE and its member teams use the most current
UCI notification guidelines to ensure randomness of testing times, dates and locations. The key to ACE's testing is the combination
of high volume of testing (numerical) and the longitudinal (over extended periods of time) analysis of the data.
Myth 1: The Current Banned Substance Testing Methods are State of the Art
The extensive use of longitudinal analysis is a significant departure from traditional anti-doping techniques
in four main ways. First, the increased collection and testing frequency allows ACE to detect possible doping earlier. Second,
the blood testing and longitudinal components of the program allows detection longer after administration has stopped. Third,
the blood-testing component also allows for detection of much lower concentrations than other anti-doping programs. Fourth,
and perhaps most importantly, the longitudinal nature of the analysis also allows the detection of potential doping by means
and substances currently undetectable by traditional anti-doping testing programs.
Relevant biological parameters (described in detail, below) have a great variation among individuals but much
smaller variation within an individual. As an example, Stimulation Index (or "Off-Score") as used by the UCI indicates possible
doping when its value exceeds 133. This absolute value is over five standard deviations from the mean of the general population.
Testing undertaken from the absolute value perspective needs to be so insensitive to accommodate the fact that the Off-Score
is over five standard deviations from the norm for the general population, but in some individuals it could be as little as
two standard deviations from that individual's normal value. In essence, some athletes can dope under the current system and
remain well under the thresholds for certain tests.
In contrast, by using longitudinal analysis, where each athlete has dozens of data points taken throughout
the season, ACE is able to be much more specific. Let us take as an example a fictional cyclist named Fred. Fred has a mean
Off-Score of 90 and a Standard Deviation of 8. If Fred recorded an Off-Score over 106, there would be only a five percent
chance that the result was from normal variation. At 114, there would be less than one-half of one percent chance that the
result was from normal variation. Both of these Off-Scores would be completely normal under traditional anti-doping (Fred
is testing under the threshold of 133 and therefore is able to race), but in the ACE program both would be an indication of
possible doping, with the Off-Score of 114 in that case being a very strong indication.
"Our testing trades specificity for sensitivity, which allows us to detect prohibited substances and methods
at lower levels and further out from the time the athlete stopped administration," explains Paul Scott. "In other words, by
monitoring the effects of these prohibited substances and methods on the body we can detect use for its entire effective duration.
In exchange for this sensitivity, we cannot tell what specific substance or method may have been used. This is markedly different
from means of direct detection of substances where evidence of that substance's presence in the body may last only a few days
or even a few hours. For example, an athlete might use EPO. Detection of that EPO use directly (in urine) might be possible
for up to four days (depending on how much was taken) by traditional anti-doping methods, but its effects on the body will
be detectable for weeks."
Myth 2: Blood Doping is Detectable for One Week or Less
To detect blood doping, ACE's PURE Sport program measures Hemoglobin, Hematocrit, Recticulocyte count and
MCV, as its main biological markers. It also uses the Stimulation Index (an indexed relationship between Hemoglobin and Recticulocytes)
as part of its primary analysis. ACE also measures several other blood factors to provide secondary clues into blood manipulation
including MCH, MCHC, RBC and Platelet Count.
Using the relationships between these biological parameters, ACE can gain a very good indication of possible
doping with even very small variations. The extensive number of parameters monitored also allows ACE to gain a very good picture
of what reasons might exist for any particular noted movement in a parameter. It is this comprehensive testing, combined with
more experience interpreting results in elite athletes than any other competing program, that allows ACE to detect doping
better than other programs, including traditional anti-doping.
Additionally, as ACE's program involves frequent, year-round testing, it is difficult for such doping to escape
detection. For example, using blood doping and the hypothetical rider Fred discussed above, traditional anti-doping would
not detect the doping at all. But, even if Fred were to have an Off-Score above the UCI limit of 133, because of the body's
feedback mechanisms, traditional anti-doping still might fail to detect the doping simply out of luck, because the testing
is not frequent enough. For example, with Fred's natural mean Off-Score of 90, if he were to administer a blood doping agent
on day that causes his next-day Off-Score to go to 135, in less than a week it would be reasonable that his Off-Score would
be below 133 (though still quite high for Fred).
Thus, under traditional anti-doping testing, a person blood doping on day 1 might be detectable for 2-6 days.
Under ACE's program, however, this doping would remain detectable for over 4-6 weeks - e.g. far longer than the athlete testing
intervals employed by ACE. Using the example above, blood doping is readily detected by ACE when traditional anti-doping would
Myth 3: Biological Ratio's (e.g. T/E) are Reliable Indicators of Steroid Use
As with blood, ACE measures an extensive number of biological parameters - in both urine and serum - to help
detect possible steroid use. Additionally, ACE screens in urine for the direct detection of over 70 substances on the WADA
banned substances list, with more being added all the time. In urine, ACE measures the biological markers testosterone, epitestosterone,
androsterone, eitocholanolone, 5a- and 5β-androstanediol. Using these six biological measurements, ACE has developed
a highly sensitive proprietary index for monitoring steroid use. ACE backs this detection method up with its serum measurement
of LH and FSH.
The longitudinal analysis of these markers is similar in kind to the blood cell analysis described above.
When a person takes an anabolic androgenic steroid ("AAS" or "steroid") that person immediately alters his body's steroid
profile. LH and FSH are immediately suppressed. This in turn suppresses the body's own steroid production, altering the biological
markers listed above for a substantial time and in a predictable manner.
As an example, in traditional anti-doping, the use of the T/E ratio is well known. Because this ratio
of biological markers is performed on a single measurement, rather than a longitudinal measurement of dozens of data points,
and because this traditional marker looks at only one marker - the ratio of testosterone to epitestosterone - the test is
too insensitive and too infrequent to detect the vast majority of steroid abuse.
WADA defines as suspect a T/E ratio of 4:1. This is over six standard deviations for the expected norm of
1:1 in the general population. Using a smaller ratio, however, would be impractical. For example, using publicly available
documents, only 3 of nearly 500 cases since 2004 where the T/E ratio was between 4:1 and 6:1 resulted in a confirmed adverse
analytical finding under the WADA system. The reason for this is the lack of frequent, longitudinal testing. In the ACE system,
again, variation from an individual athlete's norm in excess of two standard deviations is considered suspect, with a deviation
of three standard deviations being highly suspect.
Also as with blood, the frequency of testing with the ACE program allows far greater reliability. If, for
example, an individual took oral testosterone, his T/E ratio might not exceed 4:1 at all, but if it did and even if it went
as high as 30:1 or more, once the athlete stopped doping his T/E ratio could be back below 4:1 within a day, possibly sooner.
His use of testosterone under traditional anti-doping would be detectable for several more days using IRMS, but without the
elevated T/E ratio, the WADA lab would have no reason to think it should perform IRMS. Using ACE's longitudinal analysis,
oral testosterone use is easily detectable out to seven days and likely detectable out to 14 days, depending on the individual
and dose. With ACE testing occurring randomly at a minimum of once every 14 days, the ability for athletes to escape detection
Myth 4: hGH is Undetectable
ACE monitors hGH as part of its serum testing. hGH is extraordinarily difficult to detect because it returns
to normal so quickly after administration. However, ACE has had some success in detecting hGH use because of its combination
of high frequency testing and longitudinal analysis. Currently, hGH use is undetectable with traditional means of anti-doping.
Myth 5: Private Independent Anti-Doping Monitoring Programs Are Not Reliable or Supported by the Governing
Most anti-doping testing over the last twenty years was performed by governmental or governmentally supported
agencies. These programs have been traditionally under-funded and subject to political considerations. In contrast, ACE's
programs directly address doping concerns for interested stakeholders - the governing bodies, sponsors, teams, riders and
the public. While neither ACE nor participating teams can guarantee that a rider intent on cheating will get caught, it is
considerably more difficult to do so under ACE's PURE Sport program than under traditional anti-doping.
As part of its' support of the ACE PURE Sport program, UCI has agreed to accept all Team High Road and Team
Slipstream blood test results provided by ACE. The sharing of rider's blood profile information with UCI is intended for use
in conjunction with the proposed WADA rider passport program, scheduled for implementation during the 2008 season. UCI will
have access to the ACE data through role-based security protocols managed by ACE throughout the year
UCI Applauds Cycling Teams' Participation with ACE - Anne Gripper, the Manager of Anti-Doping Services for
UCI, stated: "The Agency for Cycling Ethics (ACE) assists cycling teams to create a doping-free culture by providing a robust,
independent and transparent anti-doping program. ACE collects a high volume of blood and urine samples throughout the year
which enables the creating of individual rider profiles. Programs such as the ACE PURE Sport program, provides client teams
such as Team High Road and Slipstream-Chipotle and the UCI with increased monitoring ability and certainly deters riders from
participating in any doping activities."
More information about The Agency for Cycling Ethics (ACE) (www.agencyforcyclingethics.org)