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https://www.selleckchem.com/products/lithocholic-acid.html f professional identity must not be neglected but instead further explored, as educational institutions continue to give more importance to navigating professional identity development. Chronic disease represents a large and growing burden to the health care system worldwide. One method of managing this burden is the use of app-based interventions; however attrition, defined as lack of patient use of the intervention, is an issue for these interventions. While many apps have been developed, there is some evidence that they have significant issues with sustained use, with up to 98% of people only using the app for a short time before dropping out and/or dropping use down to the point where the app is no longer effective at helping to manage disease. Our objectives are to systematically appraise and perform a meta-analysis on dropout rates in apps for chronic disease and to qualitatively synthesize possible reasons for these dropout rates that could be addressed in future interventions. MEDLINE (Medical Literature Analysis and Retrieval System Online), PubMed, Cochrane CENTRAL (Central Register of Controlled Trials), and Embase were searched from 2003 to the present to look at mobile heaion from app-based interventions, including social, demographic, and behavioral factors that could be addressed. Dropout rates in mHealth interventions are high, but possible areas to minimize attrition exist. Reducing dropout rates will make these apps more effective for disease management in the long term. International Prospective Register of Systematic Reviews (PROSPERO) CRD42019128737; https//www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42019128737. International Prospective Register of Systematic Reviews (PROSPERO) CRD42019128737; https//www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42019128737. Diagnostic delay in rare disease (RD) is common, occasionally lasting up to more than 20 years. In attempting to

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