Given the increasing use of diagnostic testing and an apparent increase in food allergy prevalence, it is vital that allergists correctly identify patients with clinical reactivity to foods as opposed to sensitization only. With the use of a detailed medical history, skin testing, and food-specific serum IgE levels, physicians can often predict the likelihood of an allergic reaction if a particular food is ingested, although in many instances the oral food challenge (OFC) is required to definitively prove tolerance.2 The double-blind, placebo-controlled OFC is the accepted gold standard for this, but such challenges can be expensive and time-consuming, and, for most practicing allergists, are often not feasible in the everyday office setting. While the open OFC is an accepted alternative, few studies have examined the test's feasibility, efficacy, and safety.
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