DBPCFCDouble Blind, Placebo-Controlled Food Challenges
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Median age at the start of symptoms of food allergy was 24 weeks and median age at DBPCFC was 56 weeks.
Single-blind placebo-controlled food challenges (SBPCFCs) and open food challenges are more readily available, but unlike DBPCFCs they do not eliminate clinician and patient bias.
Using DBPCFC, Sampson (2001) conducted a prospective study of children and adolescents and established 95% predictive decision points for egg-, milk-, peanut-, and fish-specific IgE antibody, as measured in the Pharmacia CAP System.
DBPCFCs have been used successfully in both children and adults for examining a variety of food-related complaints.
In a postmarket assessment, if IgE is detected either serologically or by skin testing, the relationship between the detected IgE and clinical symptoms may be confirmed using DBPCFC.
Positive tests should be followed by DBPCFC, under appropriate clinical observation, to correlate demonstrable IgE with clinical symptoms.
Definitive proof that a protein is a food allergen would be the observation of a clinical reaction within a short time after ingestion of the food, which is most appropriately performed in a DBPCFC (Sampson 1997).
DBPCFC for establishing reactivity) presents minimal safety concerns if done properly, and therefore the benefits outweigh the risks.
The DBPCFC is considered the gold standard for diagnosing adverse food reactions caused by any mechanism.
Diagnosis in dogs can be made by dietary restriction and rechallenge similar to the DBPCFC (dogs have no preconception of food allergy) (Strombeck and Guilford 1990).