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Background: Telepathology is a fast growing segment of the telemedicine field. As of yet, no prior research has investigated the impacts of large decentralized telepathology projects on patients, clinicians, and healthcare systems. This study aims to fill this gap. We report a benefits evaluation study of a large decentralized telepathology project deployed in Eastern Quebec, Canada whose main objective is to provide continuous coverage of intraoperative consultations in remote hospitals without pathologists on-site. The project involves 18 hospitals, making it one of the largest telepathology networks in the world., Materials and Methods: We conducted 43 semistructured interviews with several telepathology users and hospital managers. Archival data on the impacts of the telepathology project (e.g., number of service disruptions, average time between initial diagnosis and surgery) were also extracted and analyzed., Results: Our findings show that no service disruptions were recorded in hospitals without pathologists following the deployment of telepathology. Surgeons noted that the use of intraoperative consultations enabled by telepathology helped avoid second surgeries and improved accessibility to care services. Telepathology was also perceived by our respondents as having positive impacts on the remote hospitals' ability to retain and recruit surgeons., Conclusions: The observed benefits should not leave the impression that implementing telepathology is a trivial matter. Indeed, many technical, human, and organizational challenges may be encountered. Telepathology can be highly useful in regional hospitals that do not have a pathologist on-site. More research is needed to investigate the challenges and benefits associated with large decentralized telepathology networks.

Coronary artery disease (CAD) is a major health concern in both developed and developing countries. With a heritability estimated at ~50%, there is a strong rationale to better define the genetic contribution to CAD. This project involves the analysis of 884 individuals from 142 families (with average sibships of 5.7) as well as 558 case and control subjects from the Saguenay Lac St-Jean region of northeastern Quebec, with the use of 1,536 single-nucleotide polymorphisms (SNPs) in 103 candidate genes for CAD. By use of clusters of SNPs to generate multiallelic haplotypes at candidate loci for segregation studies within families, suggestive linkage for high-density lipoprotein (HDL) cholesterol is observed on chromosome 1p36.22. Furthermore, several associations that remain significant after Bonferroni correction are observed with lipoprotein-related traits as well as plasma concentrations of adiponectin. Of note, HDL cholesterol levels are associated with an amino acid substitution (lysine/asparagine) at codon 198 (rs5370) of endothelin-1 (EDN1) in a sex-specific manner, as well as with a SNP (rs2292318) located 7.7 kb upstream of lecithin cholesterol acyl-transferase (LCAT). Whereas the other observed associations are described in the current literature, these two are new. Using an independent validation sample of 806 individuals, we confirm the EDN1 association (P<.005), whereas the LCAT association was nonsignificant (P=.12).