Table IV.

Possible strategies to reduce number of oral food challenges without reducing diagnostic accuracy

Strategy	Guidance
Skin prick test	>95% positive predictive value cutoff = likely allergic especially if history of allergic reaction; allergen avoidance should be recommended 95% negative predictive value – 95% positive predictive value cutoffs = likely allergic if history of reaction; equivocal if no history, in which case challenge should be recommended <95% negative predictive value = likely tolerance, especially in absence of history of allergic reaction, in which case food consumption can be attempted
Specific IgE to extracts
Specific IgE to allergen components
Peptide-specific IgE
Basophil activation test
Home introduction of food	In absence of history of reaction and of evidence of allergen-specific IgE