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

Graded Oral Food Challenge championThe 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.

Overall Graded Oral Food Challenge Outcomes 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

Challenge outcomes for patients with a history of anaphylaxis to challenge foodA 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:

  1. Almond — 176
  2. Peanut — 163
  3. Hazelnut — 126
  4. Cashew —123
  5. Walnut — 101
  6. Egg (cooked) — 75
  7. Egg (baked) — 72
  8. Pecan — 72
  9. Milk (baked) — 49
  10. 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.

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