Effects of erythropoietin administration in training athletes and possible indirect detection in doping control / M. Audran, R. Gareau, S. Matecki, F. Durand, C. Chenard, M.T. Sicart, B. Marion, F. Bressolle. - (Medicine & Science in Sports & Exercise 31 (1999) 5 (May); p. 639-645)

• PMID: 10331881
• DOI: 10.1097/00005768-199905000-00003

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Abstract

Purpose: This study investigated the effects of repeated subcutaneous injection of rHuEpo (50 IU x kg(-1)) in athletes and proposes a method based on the measurement in blood samples of the sTfR/serum protein ratio to determine if the observed values of this marker are related to rHuEpo abuse.

Methods: Serum erythropoietin concentrations, and hematological and biochemical parameters were evaluated, during treatment and for 25 d posttreatment in nine training athletes. Moreover, the effect of rHuEpo administrations on the maximum oxygen uptake (VO2max) and ventilatory threshold (VT) of these athletes was also studied. Threshold values for sTfr and the sTfr/serum protein ratio were determined from 233 subjects (185 athletes, 15 athletes training at moderately high altitude, and 33 subjects living at >3000 m).

Results: Significant changes in reticulocytes, hemoglobin (Hb) concentration, hematocrit (Hct), sTfr, and sTfr/serum proteins were observed during and after rHuEpo treatment. The maximal heart rate of 177 beats x min(-1) at the beginning of the study was significantly higher than the value of 168 beats x min(-1) after 26 d of rHuEpo administration. Compared with the values measured at baseline, the VT measured after rHuEpo administration occurred at a statistically significant high level of oxygen uptake.

Conclusions: When oxygen uptake measured at the VT was expressed as a percentage of V02 max, the values obtained were also significantly higher. The increased values of Tfr and sTfr/serum proteins, respectively, above 10 microg x mL(-1) and 153, indicated the probable intake of rHuEpo.

TAS 2007/A/1252 FINA c/Oussama Mellouli & Fédération Tunisienne de Natation

TAS 2007/A/1252 Fédération Internationale de Natation (FINA) c. M. & Fédération Tunisienne de Natation (FTN)

CAS 2007/A/1252 FINA vs Oussama Mellouli & Fédération Tunisienne de Natation

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• Natation
• Dopage (Amphétamines – ’Adderall’)
• Négligence significative de l’athlète
• Inadéquation de la réglementation avec les circonstances particulières de l’espèce
• Début de la période de suspension

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1. Pour bénéficier de l’application de l’article DC 10.5.2 du Règlement antidopage FINA (absence de négligence ou de faute significative justifiant une réduction de la suspension), un athlète doit non seulement démontrer comment la substance interdire pénètre son organisme mais aussi qu’il ou elle n’a commis aucune faute ou négligence significative. Selon la jurisprudence du TAS, l’examen de la faute ou négligence significative doit être fait en fonction des circonstances particulières de chaque cas d’espèce. Même en état de stress et de fatigue, un sportif d’élite ne peut totalement occulter de son esprit l’obligation qui est la sienne d’éviter qu’une quelconque substance interdite ne pénètre dans son organisme. Le fait que l’usage de l’Adderall soit de plus en plus fréquent dans les universités d’Amérique du nord ne saurait excuser une telle prise de risque surtout de la part d’un étudiant de division “sport-études” qui évolue de surcroît au plus haut niveau mondial de sa discipline.

2. Exceptionnellement, la sanction prévue par l’application stricte des règles antidopage d’une fédération sportive peut apparaître disproportionnée par rapport au comportement reproché à l’athlète, et non conforme au but – à la fois répressif et éducatif – recherché par lesdites règles. Il serait particulièrement inéquitable de ne pas tenir compte des circonstances particulières de chaque espèce même si la négligence est significative et de sanctionner de la même manière celui qui refuse d’admettre avoir pris intentionnellement des produits à fort pouvoir dopant durant une longue période et qui conteste les résultats pourtant clairs des analyses et l’athlète ayant commis une négligence isolée qui s’inscrit dans le cadre d’un parcours jusqu’ici irréprochable. Il s’agit de faire preuve d’une adéquation entre la faute ou la négligence significative et la sanction dans l’application du système répressif, même si le système lui-même se veut très strict.

3. En cas de délais dans la procédure d’audition ou d’autres aspects du contrôle du dopage non imputables à l’athlète, la période de suspension peut commencer à une date antérieure, pouvant remonter à la date de la collecte de l’échantillon.

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On 8 March 2007 the Disciplinary Committee of the Tunisian Swimming Federation (FTN) decided to impose a reprimand on the Athlete Oussama Mellouli after he tested positive for the prohibited substance Amphetamine.

In this matter the Athlete had admitted the violation, accepted the test result and the provisional suspension. He explained that he had used a tablet (Adderall) at the university to stay awake for his studies.

Hereafter in March 2007 FINA appealed the FTN decision with the Court of Arbitration for Sport. FINA requested to Panel to set aside the FTN decision and to impose a 2 year period of ineligibility on the Athlete.

FINA argued that the Athlete tested positive for a prohibited substance and accordingly he had committed an anti-doping rule violation.

In view of the Athlete's conduct the Panel concludes that his Fault or Negligence was significant in this case. Considering the circumstances the Panel decides on 11 September 2007 to impose a proportional 18 month period of ineligibility on the Athlete starting on the date of the sample collection, i.e on 30 November 2006.

A comparison of the physiological response to simulated altitude exposure and r-HuEpo administration / M.J. Ashenden, A.G. Hahn, D.T. Martin, P. Logan, R. Parisotto, C.J. Gore. - (Journal of Sports Sciences 19 (2001) 11 (November); p. 831-837)

• PMID: 11695504
• DOI: 10.1080/026404101753113778

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Abstract

Concerns have been raised about the morality of using simulated altitude facilities in an attempt to improve athletic performance. One assumption that has been influential in this debate is the belief that altitude houses simply mimic the physiological effects of illegal recombinant human erythropoietin (r-HuEpo) doping. To test the validity of this assumption, the haematological and physiological responses of 23 well-trained athletes exposed to a simulated altitude of 2650-3000 m for 11-23 nights were contrasted with those of healthy volunteers receiving a low dose (150 IU x kg(-1) per week) of r-HuEpo for 25 days. Serial blood samples were analysed for serum erythropoietin and percent reticulocytes; maximal oxygen uptake (VO2max) was assessed before and after r-HuEpo administration or simulated altitude exposure. The group mean increase in serum erythropoietin (422% for r-HuEpo vs 59% for simulated altitude), percent reticulocytes (89% vs 30%) and VO2max (6.6% vs -2.0%) indicated that simulated altitude did not induce the changes obtained with r-HuEpo administration. Based on the disparity of these responses, we conclude that simulated altitude facilities should not be considered unethical based solely on the tenet that they provide an alternative means of obtaining the benefits sought by illegal r-HuEpo doping.

The ergogenic effect of recombinant human erythropoietin on VO2max depends on the severity of arterial hypoxemia / Paul Robach, Jose A.L. Calbet, Jonas J. Thomsen, Robert Boushel, Pascal Mollard, Peter Rasmussen, Carsten Lundby. - (PLoS One 3 (2008) 8 (20 August); e2996)

• PMID: 18714372
• PMCID: PMC2500186
• DOI: 10.1371/journal.pone.0002996

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Abstract

Treatment with recombinant human erythropoietin (rhEpo) induces a rise in blood oxygen-carrying capacity (CaO(2)) that unequivocally enhances maximal oxygen uptake (VO(2)max) during exercise in normoxia, but not when exercise is carried out in severe acute hypoxia. This implies that there should be a threshold altitude at which VO(2)max is less dependent on CaO(2). To ascertain which are the mechanisms explaining the interactions between hypoxia, CaO(2) and VO(2)max we measured systemic and leg O(2) transport and utilization during incremental exercise to exhaustion in normoxia and with different degrees of acute hypoxia in eight rhEpo-treated subjects. Following prolonged rhEpo treatment, the gain in systemic VO(2)max observed in normoxia (6-7%) persisted during mild hypoxia (8% at inspired O(2) fraction (F(I)O(2)) of 0.173) and was even larger during moderate hypoxia (14-17% at F(I)O(2) = 0.153-0.134). When hypoxia was further augmented to F(I)O(2) = 0.115, there was no rhEpo-induced enhancement of systemic VO(2)max or peak leg VO(2). The mechanism highlighted by our data is that besides its strong influence on CaO(2), rhEpo was found to enhance leg VO(2)max in normoxia through a preferential redistribution of cardiac output toward the exercising legs, whereas this advantageous effect disappeared during severe hypoxia, leaving augmented CaO(2) alone insufficient for improving peak leg O(2) delivery and VO(2). Finally, that VO(2)max was largely dependent on CaO(2) during moderate hypoxia but became abruptly CaO(2)-independent by slightly increasing the severity of hypoxia could be an indirect evidence of the appearance of central fatigue.

Effects of erythropoietin administration on cerebral metabolism and exercise capacity in men / P. Rasmussen, E.M. Foged, R. Krogh-Madsen, J. Nielsen, T.R. Nielsen, N.V. Olsen, N.C. Petersen, T.A. Sørensen, N.H. Secher, C. Lundby. - (Journal of Applied Physiology 109 (2010) 2 (August); p. 476-483)

• PMID: 20522733
• DOI: 10.1152/japplphysiol.00234.2010

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Abstract

Recombinant human erythropoietin (EPO) increases exercise capacity by stimulating erythropoiesis and subsequently enhancing oxygen delivery to the working muscles. In a large dose, EPO crosses the BBB and may reduce central fatigue and improve cognition. In turn, this would augment exercise capacity independent of erythropoiesis. To test this hypothesis, 15 healthy young men (18-34 years old, 74 + or - 7 kg) received either 3 days of high-dose (30,000 IU/day; n = 7) double-blinded placebo controlled or 3 mo of low-dose (5,000 IU/wk; n = 8) counter-balanced open but controlled administration of EPO. We recorded exercise capacity, transcranial ultrasonography-derived middle cerebral artery blood velocity, and arterial-internal jugular venous concentration differences of glucose and lactate. In addition, cognitive function, ratings of perceived exertion, ventilation, and voluntary activation by transcranial magnetic stimulation-induced twitch force were evaluated. Although EPO in a high dose increased cerebrospinal fluid EPO concentration approximately 20-fold and affected ventilation and cerebral glucose and lactate metabolism (P < 0.05), 3 days of high-dose EPO administration had no effect on cognition, voluntary activation, or exercise capacity, but ratings of perceived exertion increased (P < 0.05). We confirmed that 3 mo of administration of EPO increases exercise capacity, but the improvement could not be accounted for by other mechanisms than enhanced oxygen delivery. In conclusion, EPO does not attenuate central fatigue or change cognitive performance strategy, suggesting that EPO enhances exercise capacity exclusively by increased oxygen delivery to the working muscles.

• CAS 2011/A/2495 FINA v. César Augusto Cielo Filho & CBDA
• CAS 2011/A/2496 FINA v. Nicholas Araujo Dias dos Santos & CBDA
• CAS 2011/A/2497 FINA v. Henrique Ribeiro Marques Barbosa & CBDA
• CAS 2011/A/2498 FINA v. Vinicius Rocha Barbosa Waked & CBDA

CAS 2011/A/2495 Fédération Internationale de Natation (FINA) v. César Augusto Cielo Filho & Confederação Brasileria de Desportos Aquáticos (CBDA) and CAS 2011/A/2496 FINA v. Nicholas Araujo Dias dos Santos & CBDA and CAS 2011/A/2497 FINA v. Henrique Ribeiro Marques Barbosa & CBDA and CAS 2011/A/2498 FINA v. Vinicius Rocha Barbosa Waked & CBDA

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• Aquatics (swimming)
• Doping (furosemide)
• Contamination of a caffeine capsule with a diuretic
• Nature of caffeine for the purposes of the FINA Rules / WADC
• Appropriate sanction with regard to the individual athlete’s degree of fault
• Appropriate sanction to a recidivist
• Commencement of the period of ineligibility

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1. Neither the FINA Rules nor the WADC defines, or distinguishes, what is a “medication” on the one hand and what is a “supplement” on the other. Caffeine is readily available, without medical intervention, in many forms such as in energy drinks and in coffee. Moreover, an ordinary person would not regard caffeine as a medication. Therefore caffeine can be considered a “supplement” as that term is used in the comment to Rule DC10.4 (FINA Doping Control Rules). It is irrelevant, for so classifying it, that it was “prescribed” as opposed to being bought over the counter. The way the caffeine was acquired cannot change its fundamental character. It follows that Rule DC 10.4 is applicable and that Rule DC 10.5.1 is not available to the athletes. As a result, the athletes cannot establish that they bear “No Fault or Negligence” for the purpose of Rule DC 10.5.1 and that no sanction is appropriate.

2. Rule DC 10.4 prerequisites’ are satisfied where none of the alleged facts as to how the prohibited substance entered the athletes’ bodies have been contested and where it was agreed that the athlete did not wish to enhance their sportive performance. Rule DC 10.4 expressly provides that the athlete’s degree of fault is the sole criterion for determining the appropriate sanction. In this respect, the fact that the athletes have taken the necessary precautions before taking caffeine pills (prescription from their doctor, controlled pharmacy, certificate of purity of the caffeine) and that more precautions could not have been expected from them, should be taken into consideration.

3. An athlete who has committed a second doping offence is subject to Rule DC 10.7. Under this rule, a 1 year suspension which is the mandated minimum period of ineligibility does not infringe the principle of proportionality.

4. By waiving the testing of his B Sample, an athlete admits his anti doping rule violation and, in these circumstances is entitled to the benefit of Rule DC 10.9.2 which confers a discretion on a panel to determine that the period of ineligibility may start as early as the date of the sample collection.

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In May 2011 the Brazilian Water Sports Confederation, Confederação Brasileira de Desportos Aquáticos (CBDA), has reported anti-doping rule violations against the 4 Athletes after their samples tested positive for the prohibited substance Furosemide.

Here the Athletes used caffeine capsules, prescribed by their sports medicine specialist, since 2010. However the batch of caffeine capsules compounded and used in May 2011 became contaminated with the substance Furosemide in the pharmacy.

On 1 July 2011 the CBDA Anti-Doping Panel concluded that there is ‘no fault or negligence’ on the part of the Athletes and therefore decided that the appropriate sanction is a warning and the disqualification of the Athlete’s competition results.

Hereafter in July 2011 FINA appealed the CBDA decision with the Court of Arbitration for Sport (CAS).

In these cases the CAS Panel concludes that the only appropriate sanction to impose on the 3 Athletes is a warning and therefore confirms the CBDA decision of 1 July 2011.

Previously the Athlete Vinicius Rocha Barbosa Waked had committed an anti-doping rule violation in February 2010 due to inadvertently using a medicine which contained a stimulant.
As a result the Panel concludes that the Athlete has committed another anti-doping rule violation at the lowest end of the fault spectrum.

The CBDA decision of 1 July 2011 is set aside and the CAS Panel decides to impose a 1 year period of ineligibility on the Athlete, starting on the date of the sample collection, i.e. on 7 July 2011.

Therefore the Court of Arbitration for Sport decides on 29 July 2011:

In CAS 2011/A/2495 FINA v. César Augusto Cielo Filho and CBDA

1.) The Appeal filed by the Federation Internationale de Natation (“FINA”) on 8 July 2011 against Mr César Augusto Cielo Filho and the Confederação Brasileria de Desportos Aquaticos (“CBDA”) concerning the decision taken by the President of the CBDA on 1 July 2011 is dismissed.

2.) The Decision of the CBDA of 1 July 2011 is confirmed.

3.) (…)

4.) All other claims are dismissed.

In CAS 2011/A/2496 FINA v. Nicholas Araújo Dias dos Santos and CBDA

1. The Appeal filed by the Federation Internationale de Natation (“FINA”) on 8 July 2011 against Nicholas Araújo Dias dos Santos and the Confederação Brasileria de Desportos Aquaticos (“CBDA”) concerning the decision taken by the President of the CBDA on 1 July 2011 is dismissed.

2. The Decision of the CBDA of 1 July 2011 is confirmed.

3. (…)

4. All other claims are dismissed.

In CAS 2011/A/2497 FINA v. Henrique Ribeiro Marques Barbosa and CBDA

1.) The Appeal filed by the Federation Internationale de Natation (“FINA”) on 8 July 2011 against Mr Henrique Ribeiro Marques Barbosa and the Confederação Brasileria de Desportos Aquaticos (“CBDA”) concerning the decision taken by the President of the CBDA on 1 July 2011 is dismissed.

2.) The Decision of the CBDA of 1 July 2011 is confirmed.

3.) (…)

4.) All other claims are dismissed.

In CAS 2011/A/2498 FINA v. Vinicus Rocha Barbosa Waked and CBDA

1.) The Appeal filed by the Federation Internationale de Natation (“FINA”) on 8 July 2011 against Mr Vinicus Rocha Barbosa Waked and the Confederação Brasileria de Desportos Aquaticos (“CBDA”) concerning the decision taken by the President of the CBDA on 1 July 2011 is upheld.

2.) The Decision of the CBDA of 1 July 2011 is set aside.

3.) Mr Vinicus Rocha Barbosa Waked is suspended for a period of one year from 7 May 2011.

4.) Mr Vinicus Rocha Barbosa Waked’s results obtained at the Maria Lenk Swim Meet in Rio de Janeiro, Brazil in May 2011 are disqualified. The results, medals, points and prizes obtained by Mr Vinicus Rocha Barbosa Waked at the Maria Lenk Swim Meet in Rio de Janeiro, Brazil, in May 2011, are forfeited. The results, medals, points and prizes obtained by Mr Vinicus Rocha Barbosa Waked since the Maria Lenk Swim Meet in Rio de Janeiro, Brazil, in May 2011, are cancelled.

5.) (…)

6.) All other claims are dismissed.

Confirming testosterone administration by isotope ratio mass spectrometric analysis of urinary androstanediols / Cedric H. Shackleton, Andy Phillips, Tony Chang, Ye Li. - (Steroids 62 (1997) 4 (April); p. 379-387)

• PMID: 9090799
• DOI: 10.1016/s0039-128x(96)00253-x

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Abstract

A gas chromatographic combustion isotope ratio mass spectrometric (GC/C/IRMS) method was used for studying the incorporation of exogenous testosterone enanthate into excreted urinary 5 alpha- and 5 beta-androstane-3 alpha, 17 beta-diols. A multistep but straightforward work-up procedure produced a simple GC chromatogram of urinary steroid acetates composed principally of two androstanediols and pregnanediol. It is anticipated that such a method may form the basis of a doping control test for testosterone that could be used as a primary method during major sporting events or alternatively as a verification technique. Urine samples from five individuals were collected before and after administration of testosterone enanthate (250 mg). The delta 13C0/1000 value of andro-stanediols was around -26 to -28 during the baseline period and decreased to about -29 to -30 in the days following synthetic testosterone administration. One of the other major steroids in the chromatogram, pregnanediol, was utilized as the "internal standard," because its delta 13C0/1000 values did not markedly change following testosterone administration, remaining at -25 to -27. In all subjects studied, the delta 13C0/1000 values for androstanediols were reduced sufficiently over 8 days to confirm administration of synthetic testosterone. Although steroids isolated from urine of normal individuals from 12 different countries gave values between -24 and -28, this seemed not to be related to nationality or region. The most likely variable is the proportion of plants with low and high carbon 13 content in the diet. This variable is likely to be more affected by individual food preferences than broad ethnic food divisions. In this paper, we propose a ratio of delta 13C0/1000 for androstanediols to pregnanediol as a useful discriminant of testosterone misuse, a value above 1.1:1.0 being indicative of such misuse. The work-up procedure was designed for batch analysis and to use only simple techniques, rather than employ further instrumentation, such as high-performance liquid chromatography (HPLC), in purifying steroids for GC/C/IRMS.

Carbon isotope ratio (delta13C) values of urinary steroids for doping control in sport / Adam T. Cawley  1 , Graham J. Trout, Rymantas Kazlauskas, Christopher J. Howe, Adrian V. George . - (Steroids 74 (2008) 3 (March); p. 379-392)

• PMID: 19056414
• DOI: 10.1016/j.steroids.2008.11.004

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Abstract

The detection of steroids originating from synthetic precursors in relation to their chemically identical natural analogues has proven to be a significant challenge for doping control laboratories accredited by the World Anti-Doping Agency (WADA). Endogenous steroid abuse may be confirmed by utilising the atomic specificity of gas chromatography-combustion-isotope ratio mass spectrometry (GC-C-IRMS) that enables the precise measurement of differences in stable isotope ratios that arise as a result of fractionation patterns inherent in the source of steroids. A comprehensive carbon isotope ratio (delta(13)C) profiling study (n=1262) of urinary ketosteroids is reported that demonstrates the inter-individual variation that can be expected from factors such as diet, ethnicity, gender and age within and between different populations (13 countries). This delta(13)C distribution is shown by principal component analysis (PCA) to provide a statistical comparison to delta(13)C values observed following administration of testosterone enanthate. A limited collection of steroid diol data (n=100; consisting of three countries) is also presented with comparison to delta(13)C values of excreted testosterone to validate criteria for WADA accredited laboratories to prove doping offences.

CAS 2011/A/2499 Albert Subirats v. Fédération Internationale de Natation (FINA), award of 24 August 2011

Related case:
FINA 2011 FINA vs Albert Subirats
May 7, 2011

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• Aquatics
• Swimming
• Doping (Whereabouts filing failure)
• Responsibility of the athlete for making accurate and complete whereabouts filings
• Responsibility of the anti-doping organization in the notification of the filing failures

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1. It is the responsibility of each swimmer registered in the FINA Registered Testing Pool to report the required whereabouts information to the FINA office. Even when the athlete chooses to delegate whereabouts filings to a third party such as a national federation, he or she remains ultimately responsible at all times for making accurate and complete whereabouts filings. In particular, the athlete must make sure that such third party effectively forwards the whereabouts information to the anti-doping organization on time.

2. The anti-doping organization is responsible for making an accurate notification to the athlete. If it decides to notify the filing failure communication to the athlete’s national federation instead of directly to the athlete, it has to make sure that the athlete receives such communication from the national federation. If the athlete does not receive the filing failure communication from the national federation, he or she may not be declared to have committed any filing failure.

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On 21 June 2011 the International Swimming Federation (FINA) Doping Panel decided to impose a 1 year period of ineligibility on the Venezuelan swimmer Albert Subirats for 3 Whereabouts Filing Failures in 2010 and 2011.

Hereafter in July 2011 the Athlete appealed the FINA decision with the Court of Arbitration for Sport (CAS).

Uncontested in this case is the fact that the Athlete always sent the whereabouts information timely to the Venezuelan Swimming Federation (VSF). However the VSF failed to forward such information to FINA, neither for the first quarter of 2010, nor for the fourth quarter of 2010, nor for the first quarter of 2011.

In addition, uncontested and supported by the documents in the file, is the fact that the FINA notified all three filing failures by letters of 25 February 2010, 11 November 2010 and 2 February 2011 addressed only to the VSF.
No failure notices were ever sent by FINA to the Athlete directly. Also uncontested is the fact that VSF forwarded these communications to the Athlete for the first time on 2 February 2011, i.e. after the third violation had already occurred.

Since it is undisputed that the Athlete did not receive any filing failure notice before the third whereabouts filing failure, the Panel concludes that the existence of a second and a third violation cannot be reproached to the Athlete.

Therefore the Court of Arbitration for Sport decides on 24 August 2011:

1.) The Appeal filed by Mr Albert Subirats is upheld.

2.) The decision rendered on 21 June 2011 by the FINA Doping Panel is overturned.

3.) The second and the third filing failure for the fourth quarter of 2010 and the first quarter of 2011 are cancelled.

4.) Mr Albert Subirats’ results are fully reinstated.

5.) (…).

6.) (…).

7.) All other motions or prayers for relief are dismissed.

The application of carbon isotope ratio mass spectrometry to doping control / Adam T. Cawley, Ulrich Flenker. - (Journal of Mass Spectrometry 43 (2008) 7 (July); p. 854-864)

• PMID: 18523972
• DOI: 10.1002/jms.1437

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Abstract

The administration of synthetic steroid copies is one of the most important issues facing sports. Doping control laboratories accredited by the World Anti-Doping Agency (WADA) require methods of analysis that allow endogenous steroids to be distinguished from their synthetic analogs in urine. The ability to measure isotope distribution at natural abundance with high accuracy and precision has increased the application of Gas Chromatography-Combustion-Isotope Ratio Mass Spectrometry (GC-C-IRMS) to doping control in recent years. GC-C-IRMS is capable of measuring the carbon isotope ratio (delta(13)C) of urinary steroids and confirm their synthetic origin based on the abnormal (13)C content. This tutorial describes some of the complexities encountered by obtaining valid delta(13)C measurements from GC-C-IRMS and the need for careful interpretation of all relevant information concerning an individual's metabolism in order to make an informed decision with respect to a doping violation.