Graded Oral Food Challenge
A Graded Oral Food Challenge (GOFC) is the “gold standard” for confirming specific food allergies or the absence of following treatment. If your provider believes that you are a candidate based on your history, exam, testing, and previous treatment, a GOFC may be recommended.
The Graded Oral Food Challenge is a valuable tool to help answer questions about food allergy treatment progress, whether avoiding certain foods is necessary, or if a food can be safely reintroduced into the diet.
The Graded Oral Food Challenge will help your provider:
- Determine how allergic you may be to a specific food
- Evaluate the effectiveness of allergy drop treatment
- Determine if you/your child has outgrown a food allergy
The challenge also provides diagnostic information allowing your medical team to further modify your treatment.
During a challenge, we test only one food at a time using a detailed protocol and designated food challenge suite that is closely monitored by a specially trained medical team. The specified food will be given in timed intervals at pre-calculated amounts.
Our challenge protocol integrates the best practices from leading food allergy centers that provide food challenges. Our team and facility are equipped with state-of-the art technology and training to address the many facets of food challenges in a safe, comfortable environment.
For details about the Graded Oral Food Challenge and whether you might be a candidate, please talk with your provider at your next scheduled visit.
Graded Oral Food Challenge Reports
April 2023 GOFC Report
Allergy Associates of La Crosse initiated a Graded Oral Food Challenge (GOFC) program in spring 2016.
The objective of challenges, which typically take 3-4 hours, is to eat a full serving of a food in graded increments, with detailed patient observations before, during, and after the challenge.
As of spring 2023, a total of 1,235 challenges have been performed that provide the data for this report:
- Passed = 86.3%
- Partial Pass = 4.8%
- Failed = 7.6%
- Not conclusive results = 1.4%
When including partial pass challenges into the results, an impressive 91.1% success rate has been achieved.
Patient selection is driven by detailed metrics of their conditions (comorbidities), history of testing and treatment including: Specific IgE, Total IgE, skin prick testing, treatment duration/level, history of severe reactions, several other measured criteria, and provider judgement.
Key Report Findings
A KEY finding of our program is the large number of patients with a history of food anaphylaxis (n=438 or 35.5% of all challenges):
- 86.1% of the patients with any history of anaphylaxis passed their challenge
- 4.1% partially passed
- 9.3% failed
Of the 438 with anaphylaxis,142 patients were challenged directly to their anaphylactic food (n=142):
- 77.5% passed their challenge
- 10.6% partially passed
- 11.3% failed their challenge
General results of the program challenges:
Basic demographics of challenge patients:
- Age: Average patient age = 14 years. The youngest is 2; oldest is 91.
- Gender: 817 Males, 418 Females
- Average years of sublingual immunotherapy at time of challenge: 4.41 years
Most Common Foods Tested:
- Almond — 176
- Peanut — 163
- Hazelnut — 126
- Cashew —123
- Walnut — 101
- Egg (cooked) — 75
- Egg (baked) — 72
- Pecan — 72
- Milk (baked) — 49
- Shrimp — 40
Safety Statistics
From a safety standpoint in all challenges, epinephrine use occurred four times (0.32%). No patients required or reported follow-up at an Emergency Center, and no patients were admitted to a hospital.