Table I.

Samples of indications for hospital oral food challenges

Indication	Reason or example	Settings where used
Investigation or diagnostic procedure
Diagnostic clarity when history and other testing are equivocal	Lack of recent reaction or uncertain reaction history reduces pretest probabilities and oral provocation becomes necessary	Clinical and research settings
Threshold determination	To assess exposure level required to produce clinically observable allergic reaction (with fixed symptom criteria) at single time point, often before other therapeutic interventions (eg, immunotherapy), after which threshold may be reassessed	Typically used in research trials, increasingly used in clinical settings
Assessment for resolution when history or other testing is suggestive	Downward trends in consecutive sensitization results, in absence of recent high-certainty reactions or history suggestive of non-reactivity upon accidental exposure	Clinical setting
Therapeutic procedure
Supervised and supported experience of reaction in controlled setting	To confirm ongoing allergy when patient doubts diagnosis and exhibits risk-taking behaviors	Clinical setting
Demonstrating tolerance to low-exposure amounts when allergy is confirmed	When significant anxiety might exist regarding non-ingestion contact or non-contact reactions, or to aid low-level allergen introduction	Clinical setting