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November 13, 1996

Drug Testing in Sport: Bayes Theorem Meets Advanced Technology-Reply

Author Affiliations

University of California, Los Angeles

JAMA. 1996;276(18):1471-1472. doi:10.1001/jama.1996.03540180027022

In Reply.  —Testing for performance-enhancing drugs is designed to be 100% specific, and with respect to the laboratory that produced the data in Tables 2 and 3 of our article, there is no evidence to the contrary. No false-positive results have occurred in 12 years of accreditation and proficiency testing, and despite numerous reviews by experts, none of the positive cases have been found to be in error. This 100% accuracy for positive results is achieved primarily by properly using a definitive analytic technique to identify compounds. Technical measures of test validity are important but are only part of the story. In addition, unlike many workplace drug-testing programs, testing of athletes includes collecting the urine under direct observation, splitting the urine into 2 portions, analyzing 1 sample at least twice (screen and confirmation) on separate occasions before reporting the result of that specimen, and requiring the analysis of the second portion of