In proper competitive gaming (ie. with a prize pool) you can apply much more rigorous standards like kyc, a live video feed; even standardized hardware and drug tests.
In magic the gathering, the standards are divided in three: casual (called regular), competitive and professional. Basically the competitive mode is for people who play the game to win, sometimes with small prizes, but still want a very clean playing field. I feel that the standardized hardware and drug tests are feasible at professional, but not competitive, and anti cheat rootkits is interesting in competitive.