Doping prevalence in competitive sport: Evidence synthesis with “best practice” recommendations and reporting guidelines from the WADA Working Group on Doping Prevalence

Abstract

The primary aim of this subject- wide systematic review was to collate and synthesize evidence on doping prevalence from published scientific papers. Secondary aims involved reviewing the reporting accuracy and data quality as evidence for doping behavior to (1) develop quality and bias assessment criteria to facilitate future systematic reviews; and (2) establish recommendations for reporting future research on doping behavior in competitive sports to facilitate better meta-analyses of doping behavior. Using PRISMA guidelines, 105 studies, published between 1975 and 2019, were included. To determine prevalence, the majority (89/205 studies) used self-reported surveys. Doping prevalence rates in competitive sport ranged from 0% to 73% for doping behavior with most falling under 5%. Inconsistencies in data reporting prevented meta-analysis for sport, gender, region, or competition level. Qualitative syntheses were possible and provided for study type, gender, and geographical region. Current knowledge about doping prevalence in competitive sport relies upon weak and disparate evidence. To address this, we offer a comprehensive set of assessment criteria for studies examining doping behavior data as evidence for doping prevalence. To facilitate future evidence syntheses and meta-analyses, we also put forward “best practice” recommendations and reporting guidelines that will improve evidence quality.

The athletic characteristics of Olympic sports to assist anti‐doping strategies

“…The ADOs are encouraged to carefully consider the spectrum of these various parameters and identify the extent of how these will inform the development of their balanced TDP. Identifying the real doping prevalence remains the holy grail quest in the anti‐doping field 33 . Conducting an effective doping prevalence assessment is challenging for many reasons.…”

Dealing with doping. A plea for better science, governance and education

“…Research has identified a range of motivations across competitive levels 25 , though at the elite levels of sport, money was identified as a primary factor 26,27 , making the drive to win greater than fear of the associated risks. Real prevalence of doping is impossible to measure, and estimates vary widely and may be flawed 28 . However, prevalence models routinely show doping rates of 10-60% depending on country, sport and level [29][30][31] .…”

“…A network of national anti-doping organizations (NADOs) and anti-doping laboratories now cooperate under the umbrella of WADA. This collective effort has led to sizable changes in doping behavior and prevalence 28 . These well-intended anti-doping efforts have surely changed athletes' doping patterns and how doping is perceived by athletes and the public.…”

“…Real prevalence of doping is impossible to measure, and estimates vary widely and may be flawed. 28 However, prevalence models routinely show doping rates of 10-60% depending on country, sport and level. [29][30][31] In any case, these numbers are much higher than those published by WADA, reporting that only 1-2% of samples return positive, possibly giving the impression that the testing system is easy to beat.…”

“…This collective effort has led to sizable changes in doping behaviour and prevalence. 28 These well-intended antidoping efforts have surely changed athletes' doping patterns and how doping is perceived by athletes and the public. After 2 decades, the question is by how much these achievements cover the objectives stated at the inception of WADA and what the outlook is for the coming decades.…”