Quantitative Allergy Testing in Korea: Current Status and Diversification of External Quality Assessment Items

Background: With the increasing prevalence of allergic diseases, quantitative allergen-specific immunoglobulin E testing has become essential in clinical diagnosis and patient management.However, the external quality assessment (EQA) program for allergy testing in Korea operates with variable test items across cycles, raising concerns regarding its clinical representativeness.Methods: Data from the Korean Association of External Quality Assessment Service allergy testing program from 2020 through the first half of 2025 (11 rounds) were analyzed.A nationwide survey of participating laboratories was also conducted to assess allergen test items, testing volumes, and laboratory practices.The frequency of allergen inclusion in EQA was compared with real-world testing patterns.Results: House dust mite allergens (Dermatophagoides pteronyssinus and Dermatophagoides farinae) and animal dander allergens (cat and dog) were both frequently tested in clinical laboratories and consistently included in EQA programs.Common food allergens, including egg white, peanut, milk, and wheat, were also widely tested and moderately represented in EQA.In contrast, several pollen allergens, including ragweed, mugwort, oak, and tree pollen mixtures, were commonly tested in laboratories but were rarely or never included in EQA rounds.These findings indicate a discrepancy between clinical testing demand and EQA item selection.Conclusions: Current EQA programs for quantitative allergy testing in Korea partially reflect real-world clinical practice but have limited coverage of diverse allergen panels.A balanced approach incorporating both core highfrequency allergens and rotating supplementary items may improve the effectiveness and clinical relevance of EQA programs.