JMIR Publications

ABSTRACT

Background:

Sample pooling is an essential strategy for optimizing polymerase chain reaction (PCR) resources during infectious disease outbreaks, especially in the beginning. While high-dimensional hypercube pooling strategies—such as those recently highlighted in Nature—offer superior efficiency in low-prevalence settings, they are difficult to implement in practice. The human cognitive and physical limitation to three-dimensional environments makes manual execution of four- or five-dimensional sample arrays prone to significant operational error.

Objective:

To develop and evaluate a novel "Ternary Card Hypercube Pooling" strategy that simplifies the implementation of multidimensional pooling, making it accessible for laboratory personnel without compromising mathematical efficiency.

Methods:

We integrated logic from ternary card games (based on sets of three attributes) to create a visual and physical framework for hypercube pooling. This method maps high-dimensional coordinates onto a simplified "card" system, allowing laboratory technicians to organize and track samples using intuitive pattern recognition rather than complex multidimensional mapping.

Results:

The Ternary Card method successfully translates the efficiency of hypercube pooling into a user-friendly workflow. It maintains the high performance of traditional hypercubic algorithms—allowing for rapid identification of positive samples in a single step in the majority of cases—while significantly reducing the risk of manual pipetting errors and the need for specialized automated equipment.

Conclusions:

The Ternary Card Hypercube Pooling strategy bridges the gap between theoretical mathematical efficiency and practical laboratory application. By reducing the complexity of sample handling, this method provides a scalable solution for increasing PCR throughput in response to future pandemics, particularly in resource-limited settings. Clinical Trial: NA