To the Editor: The recently published National Institute of Allergy and Infectious Diseases-sponsored "Guidelines for the diagnosis and management of food allergy in the United States"1 and the "Work group report"2 both state that oral food challenge (OFC) is a critical procedure for the evaluation of food allergy. Allergist 77.4 Registered nurse 55.2 Medical assistant 26.1 Nurse practitioner 10.9 Physician's assistant 4.6 Other 9.1 Average duration of OFC procedure visit <1 h 1.3 1-2 h 27.0 3-4 h 63.6 5-6 h 7.4 >6 h 0.7 Table I Effort and personnel involved in OFCs Barrier Response rate (%) Response count Lack of time 55 292 Reimbursement 53.7 285 Risk of adverse event 51.8 275 Lack of staff 44.3 235 Lack of office space 27.1 144 Lack of experience 11.5 61 No nearby hospital 7.9 42 Lack of need 2.6 14 Other 9.2 49 Total