How Accurate are your Allergy Tests?

Written by: UK NEQAS IIA, published on: 9 Jun 2025

Ensuring accuracy in allergen component testing is essential for maintaining laboratory standards and delivering trustworthy diagnoses to your patients. External Quality Assessments play a crucial role in ensuring that laboratories maintain a high level of accuracy when handling allergy components.

What is an External Quality Assessment?

An external quality assessment (EQA) , also known as a Proficiency test, evaluates a laboratory's by comparing its results with those from peer laboratories. This process provides confidence in test outcomes and affirms the reliability of the laboratory’s procedures.

An EQA assessment is carried out by an independent, external provider, who references established benchmarks to ensure laboratories' results and findings are accurate.

Participation not only reinforces trust among staff and patients but also highlights areas for improvement and supports quality assurance goals.

What is Allergen Component Testing (Component Resolved Diagnostics)?

Allergen component testing, also known as Component Resolved Diagnostics (CRD), identifies the specific proteins within an allergen that are triggering a patient’s allergic reaction. Compared to whole allergen extract tests, component testing offers greater specificity and diagnostic value.

This method is preferred when:

Determining true allergies without interference from cross-reactive allergens.
Predicting severity of allergic reactions based on high-risk components.
Identifying suitable candidates for immunotherapy, as certain components respond better to targeted treatments.

Why Accuracy is Important in Allergy Component Testing?

Different allergy testing methods serve different clinical needs. The skin prick test is commonly used but may not be appropriate for all patients, especially those at risk of severe reactions or with certain skin conditions such as eczema or psoriasis.

In such cases, allergen component testing is a safer and more precise option. However, the accuracy of this testing is critical. Without proper quality assurance, results may vary across laboratories, potentially leading to:

Misdiagnosis or delayed diagnosis.
Continued exposure to allergens.
Inappropriate treatment plans.
Reputational and legal risks for the laboratory.

What Could Influence the Accuracy of an Allergy Component Test?

Improper Sample Handling - Once collected, blood samples must be handled correctly in order to avoid degrading. Samples should be stored at the correct temperature and processed within a few hours of collection in order to avoid protein degradation.

Equipment Management - Allergy component tests require the use of various pieces of equipment, all of which must be maintained and stored correctly in order to avoid interfering with test results.

How to Choose an External Quality Assessor (EQA) for Allergy Component Testing

It is important to choose an external quality assessor (EQA) that is reputable and fully accredited, specifically to ISO/IEC 17043, the standard for proficiency testing providers. Other key elements to consider when choosing an EQA include:

Specialisation in Allergen Component testing

Ensure you choose an EQA provider specialising in Allergen Component Testing, as opposed to whole allergen extracts, as testing and accuracy requirements differ significantly

Comprehensive Reporting and Feedback

A valuable EQA programme should provide detailed feedback, benchmarking your performance against other laboratories and offering root cause analysis for any discrepancies. This enables you to develop action plans for continuous improvement.

Opt for an EQA provider who delivers detailed EQA reports which include an analysis of your performance compared to your peers, and root cause analysis for any underperforming results.

How UK NEQAS IIA can help ensure your allergy component testing is accurate?

UK NEQAS for Immunology, Immunochemistry & Allergy (IIA) offers a dedicated EQA programme for allergen component testing, designed to assess your laboratory’s ability to detect allergen-specific IgE antibodies—including those for venom, egg, nuts, latex, birch, and milk.

Using blind samples, we evaluate your lab’s results against those from other participating laboratories worldwide. This process helps identify performance inconsistencies, offers insights into accuracy, and promotes best practices in allergy testing.

Any inconsistencies can then be flagged, allowing you to gain valuable insights into performance and areas for improvement, and adopt best practices in laboratory medicine.

Our programme operates on a bi-monthly schedule, ensuring frequent assessment opportunities to flag errors early and support ongoing improvements.

For more information on our allergen component testing, read our online resource or contact us for more information.