Background and aims: Successful transfer of adolescent IBD patients to an adult gastroenterologist requires anticipation of a changing role for patients and their parents. Self-efficacy has been demonstrated to be important for transfer readiness. We therefore developed an IBD-specific questionnaire (the "IBD-yourself") to assess self-efficacy in adolescent IBD patients visiting a transition clinic. Our aim was to evaluate the reliability of this questionnaire, and to describe the self-efficacy level of adolescent IBD patients, and the perceived self-efficacy level according to their parents. Methods: In a cross-sectional design, 50 IBD patients (aged 14-18 years) and 40 parents completed the "IBD-yourself" questionnaire. Internal reliability was assessed by standardised Cronbach's α. Median self-efficacy scores per domain were calculated. Results: The domains of the questionnaire for adolescents showed good to excellent internal consistency, with Cronbach's α ranging from 0.64 to 0.93. The domains of the parental questionnaire had Cronbach's α ranging from 0.47 to 0.93. Median self-efficacy scores of adolescents varied from 70 to 100%. In comparison with patient's self-assessment, parents thought that their child was more A v a i l a b l e o n l i n e a t w w w . s c i e n c e d i r e c t . c o m ScienceDirectJournal of Crohn's and Colitis (2013) 7, e375-e385 Downloaded from https://academic.oup.com/ecco-jcc/article-abstract/7/9/e375/427279 by guest on 07 June 2019 self-efficacious in knowledge of IBD and diagnostic tests, self-management of medication use, and transfer readiness. Length of time since first visit to the transition clinic was positively correlated with several domains of the questionnaire, such as independent behaviour at the outpatient clinic, and transfer readiness. Conclusion: The "IBD-yourself" questionnaire is a first step toward evaluating quality and efficacy of IBD transition programmes. Paediatric gastroenterologists should be aware that parents do not always accurately assess the self-efficacy of their child.

Nearly two-thirds (63%) of the adolescents who attended the IBD transition clinic had a successful transition to adult care.

with great interest the article by Bjo ¨rck et al (1). The authors concluded that repeated screening using tissue transglutaminase antibodies is necessary to identify new cases of coeliac disease (CD) by 9 years of age. Furthermore, they affirm that CD screening can be restricted to children carrying HLA-DQ2 and/or DQ8.I would like to point out that the age of 9 years is perhaps a critical age from the evolutionary point of view. In my opinion, the gluten-free diet may be more accepted in earlier stage, during entry into primary school (2). In order to achieve effective guidelines, it is useful to make a rationalization of instruments useful for diagnosis.It has been demonstrated that when the pretest probability of CD is low, patients with positive tissue transglutaminase serology should undergo oesophagogastroduodenoscopy with biopsyeither directly or after positive screening for HLA DQ2/8-to confirm CD. ( 3).It appears that the awareness of genetic testing (GT) is high among CD support group members. Efforts should be made to increase the knowledge of GT in those with a lower educational level, and health care professionals should attempt to address the concerns regarding GT cost and the impact of results on health care and insurance status (4).In conclusion, I wish to advocate the need for GT in population, but to suggest that targeted screening programs in the early stages of childhood should be organized to get the best possible adherence to the gluten-free diet.

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