How is a double-blind, placebo-controlled food challenge performed in the workup of food allergies?

Updated: Feb 05, 2020
  • Author: Scott H Sicherer, MD; Chief Editor: Michael A Kaliner, MD  more...
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DBPCFC involves supervised, gradual ingestion of the suspected food disguised in another food (or hidden in capsules). A food similar in taste and appearance, but without the allergen, is used as a placebo control. The feeding (potential allergen vs placebo) is randomized so that the patient and the observer are unaware of the contents of the challenge at the time of the feeding and observation. Feeding of the allergen and placebo may be separated by hours or days. [64]

This type of challenge is designed to reduce patient and observer bias and subjective attitudes during the procedure. DBPCFC is considered the criterion standard for diagnosing food allergies and is particularly used in research investigations. Currently, it is the only completely objective method for determining the validity of the history of an adverse reaction to a food.

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