Rotterdam Transition Test: A Valid Tool for Monitoring Disease Knowledge in Adolescents With Inflammatory Bowel Disease

Martha A.C. van Gaalen, Merel van Pieterson, Gertrude van den Brink, Lissy de Ridder, Dimitris Rizopoulos, C. Janneke van der Woude, Johanna C. Escher*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

3 Citations (Scopus)


Objectives: Disease knowledge is important in adolescents with inflammatory bowel disease (IBD) transitioning to adult care. We developed an IBD-specific knowledge questionnaire, the Rotterdam Transition Test (RTT), and aimed to validate this tool. Methods: This is a prospective longitudinal validation study. The RTT has 25 open questions on IBD, medication, lifestyle, and transition to adult care. A scoring model was developed, and inter-rater agreement was assessed. Using a Rasch model, we determined the difficulty and performance of the questions. Cronbach alpha was used to demonstrate reliability. Patient factors (age, disease, education, medication use, illness acceptance, and independence) were correlated to RTT score. Results: A total of 207 RTTs were evaluated in 111 adolescent IBD patients. The scoring model showed a kappa score of >0.61 for all questions. Reliability with Cronbach alpha was good (0.81). Mean total result of the RTT was 58% (girls) and 55% (boys) of maximal score. The RTT discriminated well between the different levels of knowledge. Knowledge scores increased in patients who did repeated RTTs during the transition period. Male sex, low educational level, disease acceptance issues, and dependence on parents associated with a significantly lower total RTT score. Prednisone use within 3 months and treatment without biologics associated with significantly higher RTT scores. Disease activity was not a significant factor. Conclusions: The RTT is a reliable and valid tool to assess IBD knowledge. The RTT can be used to detect and discuss knowledge gaps in adolescents with IBD transitioning to adult healthcare.

Original languageEnglish
Pages (from-to)60-67
Number of pages8
JournalJournal of Pediatric Gastroenterology and Nutrition
Issue number1
Publication statusPublished - 1 Jan 2022

Bibliographical note

Funding Information:
This work was supported by the Erasmus MC; evidence-based care of nursing (2016-16407).

Funding Information:
J.C.E. served for a scientific advisory board for Janssen and Abbvie, and received a research grant from MSD, outside the submitted work. L.d.R. has done research consults for Celltrion and Abbvie, received grants from Pfizer outside the submitted work. J.v.d.W. served as a speaker for Celltrion, on the advisory board for Norgine (personal fees), and received research funding from Pfizer outside the submitted work. The remaining authors report no conflicts of interest.

Publisher Copyright:
Copyright © 2021 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition.


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