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Doping Prevalence in Sport from Indirect Estimation Models: A Systematic Review and Meta-analysis.

This systematic review and meta-analysis pooled studies that used indirect survey methods to estimate how many athletes admit to doping. The authors searc…

Signal score64Research triage score
CertaintyModerateVerify in full text
PMID42251609Source identifier
Research triage, not medical advice

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Plain-English signal

This systematic review and meta-analysis pooled studies that used indirect survey methods to estimate how many athletes admit to doping. The authors searched databases through March 2025 and included 46 records (30 included in the meta-analysis representing 34 independent studies). Indirect methods like Unrelated Question and Forced Response techniques were commonly used to reduce underreporting. Results reported lifetime and past-year admitted doping: lifetime prevalence was highest among multi-sport competitive athletes (about 22.6%) and lowest for single-sport competitive athletes (about 12.7%); past-year prevalence was highest for single-sport recreational participants (about 15.5%) and lowest for multi-sport recreational participants (about 8.7%). The review concludes that admitted doping varies by sport type and competition level and notes challenges when studies re-use existing datasets. The review is registered in PROSPERO (CRD42022373691).

Why it matters

  • Provides pooled estimates of admitted doping prevalence using indirect estimation models (IEM) across sports and competition levels, informing the scale of doping in athletic populations.
  • Findings differentiate lifetime vs. past-year prevalence and compare multi-sport vs. single-sport and competitive vs. recreational participants, which matters for targeting anti-doping surveillance, education, and policy.
  • Estimates derived from IEMs (e.g., Unrelated Question, Forced Response with Cheater Detection) address underreporting biases in self-report and can change prevalence assumptions used by researchers, sports governing bodies, and anti-doping agencies.

Effect summary

Abstract-reported pooled estimates: lifetime admitted doping highest in multi-sport competitive athletes (~22.6%) and lowest in single-sport competitive athletes (~12.7%); past-year admitted doping highest in single-sport recreational sportspersons (~15.5%) and lowest in multi-sport recreational sportspersons (~8.7%).

Benefit-cost lens

Quick takeThis meta-analysis updates prevalence estimates of self-admitted doping using indirect methods; it may inform prioritization of anti-doping resources but cannot alone justify interventions without cost, program effectiveness, and local baseline data.
BCR anchor2
Time horizon3
Discount rate0.03
AssumptionsAssessment based on PubMed metadata and abstract only; full-text verification needed for methods, heterogeneity, subgroup definitions, and exact pooled estimates before cost-effectiveness modeling.

Benefit-cost fields are assumptions-based unless explicitly source-derived. Treat them as prompts for deeper economic review.

Risk of bias

Toolrapid-abstract-screen
VerdictSome concerns
NotesAssessment based only on PubMed metadata and abstract. The study is a systematic review/meta-analysis which can be high-quality, but abstract does not detail heterogeneity, risk-of-bias assessments of included studies, how non-independence from re-analysed datasets was handled, or sensitivity analyses. Full-text appraisal required.

Harms, equity, conflicts & implementation

ImplementationFull-text review, extraction of stratified prevalence estimates and uncertainty intervals, assessment of study heterogeneity and bias, local population denominators, costing of interventions, stakeholder consultation, and pilot evaluation framework.
Equity impactUnclear from abstract; equity implications depend on whether prevalence and access differ by region, socioeconomic status, gender, or sport type - full text needed to assess subgroup impacts.
HarmsHarms (e.g., stigmatization, misuse of prevalence estimates, policy overreach) are not reported in the abstract; potential harms depend on how prevalence estimates are used in policy or enforcement.
RegistrationCRD42022373691
ReplicationUnknown from automated PubMed triage; replication or independent corroboration not reported in abstract.

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