5 91 Standardized Pain Mapping for Diagnosing Achilles Tendinopathy Statistical analysis We assessed data for having a normal distribution using the Shapiro Wilk test. Normally distributed data are presented as mean with standard deviation (SD) and non-normally distributed data as median with interquartile range (IQR). We evaluated the utility of the pain map by determining the level (%) of agreement between the presence of patientreported pain on the pain map and the physician-determined diagnosis. The level of agreement between the patient-reported pain map results and the physician-determined diagnosis was also calculated using the Cohen’s Kappa coefficient and 95% confidence intervals (CI). We calculated both percent agreement and kappa based on recommendations in existing literature.19 We interpreted a Kappa coefficient of 0–0.20 as slight, 0.21–0.40 as fair, 0.41–0.60 as moderate, 0.61-0.80 as substantial and 0.81-1.0 as almost perfect agreement.20 The same procedure was done for the location of the pain and the location of the diagnosis. We used SPSS software (V.24.0.0.1; SPSS, USA) for statistical analysis. RESULTS 111 patients were referred to the outpatient department of the Erasmus MC because of symptoms in the region of the Achilles tendon. All referred patients received a digital questionnaire and completed the questionnaire before their appointment. One patient was excluded due to the fact that there was no pain in the Achilles tendon region anymore at the time of the appointment with the sports physician. The mean (SD) age in our study population was 48 (13) years with the majority (61%) being male. The mean (SD) Body Mass Index (BMI) was 26.2 kg/m2 (4.5). The majority of the patients (76%) practiced one or more sports. Unilateral symptoms were reported in 65% of the patients. 38 of the 39 patients with bilateral symptoms had symptoms in the same region (midportion/insertional) of the tendon on both sides. Consequently, the same clinical diagnosis was made for both Achilles tendons in 38 of these 39 patients (97%). The patient characteristics are displayed in Table 1.
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