Enhancing chronic cough management in primary care using a web-based clinical decision support system (My Chronic Cough Guru – MyCCG): a mixed-method utility and usability evaluation study

Managing chronic cough presents significant challenges for primary care doctors in Malaysia. This study used a mixed-methods approach to evaluate the utility and usability of “My Chronic Cough Guru” (MyCCG), a web-based clinical decision support system developed to support primary care doctors in managing chronic cough in Malaysia. The retrospective think-aloud approach was used to gather qualitative feedback while a questionnaire comprising Post-Study System Usability Questionnaire (PSSUQ) and confidence items were used to gather quantitative outcomes from twenty primary care doctors at a tertiary hospital. The qualitative data were analysed according to utility and usability. Within each category, thematic analysis was done to summarise the findings. Quantitative data were analysed descriptively and compared with the qualitative findings for triangulation purpose. Qualitative findings showed that participants perceived MyCCG as a comprehensive clinical decision support tool that facilitated structured diagnosis, management, and follow-up of chronic cough. It was considered particularly valuable for managing complex cases and as an educational resource for junior doctors. Participants recommended integration with existing clinical systems and refinements to navigation, including reducing scrolling and “click fatigue”, to improve workflow efficiency. Quantitatively, the mean overall PSSUQ score was 2.51 ± 1.14 (1–7 scale: lower scores indicate better perceived usability). Most participants agreed that MyCCG would improve chronic cough management (75%), diagnostic accuracy (75%), facilitate earlier resolution (70%), and was feasible for implementation in clinical practice (75%). The utility and usability of MyCCG was acceptable to the doctors. Once refinement is done, its implementation feasibility should be further assessed in real-world clinical practice.