Published on 2 Nov 2025

Developing a Clinical Pathway for Debilitating Symptom Complexes Attributed to Ticks (DSCATT)

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Allen + Clarke partnered with the Department of Health, Disability and Ageing to develop Australia's first evidence-based clinical pathway for patients suffering from Debilitating Symptom Complexes Attributed to Ticks (DSCATT). Through rigorous research and inclusive stakeholder engagement, we created a flexible framework that bridges patient and medical needs, delivering a practical tool that helps clinicians navigate complex diagnostic challenges while supporting better patient outcomes nationwide.

Key Takeaways:

  • Extensive stakeholder consultation, with medical professionals, patient groups and government bodies, ensured the clinical pathway reflected diverse perspectives and practical realities of patient care.

  • Evidence-based educational materials were developed and user-tested with key stakeholders to ensure scientific validity and stakeholder acceptance.

  • The resulting clinical pathway provides a structured yet flexible tool that supports clinicians in assessing and managing patients with varied symptoms and severity of disability
Read the Framework here
The pathway was formally endorsed by the Australian Health Ministers' Advisory Committee and its subcommittees, signifying its acceptance at the highest levels of Australia's health system. This project demonstrates how evidence-based approaches, combined with inclusive stakeholder engagement, can address complex health challenges effectively.

The Challenge

The Department of Health, Disability and Ageing develops and delivers policies and programs for the Australian health sector and the public. Following the 2016 Senate Community Affairs References Committee's Inquiry into emerging tick-borne disease causing Lyme-like illness, the Australian Government committed to addressing Recommendation 5: developing a cooperative multidisciplinary framework to accommodate both patient and medical relating to DSCATT.

The challenge was significant. Patients suffering from DSCATT often present with complex, varied symptoms that can be difficult to diagnose and treat effectively. Many experience prolonged diagnostic journeys, moving between specialists without clear pathways for care. The Government needed a solution that could be applied across both private and public health settings while being evidence-based and acceptable to all stakeholders.

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Our Approach

Allen + Clarke brought expertise in collaborative healthcare framework development and stakeholder engagement to create a practical solution. Our approach combined rigorous evidence review with inclusive consultation to ensure the resulting pathway would be both scientifically sound and implementable in real-world settings.

Our collaborative approach meant the pathway was developed with input from those who would ultimately use it, increasing the likelihood of acceptance and implementation. This was particularly important given the sometimes contentious nature of DSCATT diagnosis and treatment.

We implemented a comprehensive, staged methodology:

  • Literature review - we conducted an integrative review of peer-reviewed and grey literature published since January 2008, using carefully developed search parameters to identify relevant evidence.

  • Think Tank facilitation - we brought together key stakeholders including medical professionals, government health authorities and patient groups to inform development of the initial pathway.

  • Nationwide consultation - we engaged stakeholder groups across Australia through face-to-face meetings, virtual sessions, focus groups and written feedback to refine the pathway.

  • User testing - we tested educational materials with key stakeholders to ensure messaging was fit for purpose, scientifically valid and acceptable to all parties.

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Australia’s first comprehensive clinical pathway for DSCATT patients

The result was Australia's first comprehensive clinical pathway for DSCATT patients. This practical tool supports decision-making on differential diagnosis and referral pathways for patients presenting with either new onset or unresolved debilitating symptoms that cannot be attributed to another condition, with or without a history of tick bites.

Building on this foundation, we developed a suite of educational materials including five evidence-based Guidance Notes for clinicians in community and hospital settings and nine Factsheets for consumers. These resources provide accessible, scientifically valid information on DSCATT topics, helping to bridge knowledge gaps among both healthcare providers and the public.

The DSCATT Clinical Pathway has delivered significant benefits:

  • Improved clinical decision-making - the pathway provides structure for assessment and management while allowing flexibility for individual patient circumstances.

  • Enhanced patient experience - clearer diagnostic and referral processes reduce the frustration of diagnostic uncertainty and inappropriate referrals.

  • Better health system efficiency - structured approaches to complex conditions help optimise resource use and improve coordination between healthcare providers.

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