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    Methodology and evidence base

    What We Measure, How We Aggregate, What Is Gated

    Reference page for NIHR reviewers, occupational medicine researchers, ICB and employer commissioners.

    • OccuFertility is an information and templates resource, not a medical device.

    4 instruments

    Instruments and Licensing

    Every patient-reported instrument used in OccuFertility is either public domain or licensed for commercial use.

    We deliberately avoid instruments that would block free embedding (for example WEMWBS commercial, EQ-5D-5L commercial) until the relevant licence is in place on a separate track.

    • PHQ-4 (Patient Health Questionnaire-4)

      Purpose
      Short anxiety and depression screen for self-reflection.
      Licence
      Public domain. No fee.
      Role on platform
      Optional, embedded in the wellbeing check-in.
    • WAI-1 (Work Ability Index, Single Item)

      Purpose
      Single-item work ability self-rating (0-10).
      Licence
      Public domain (Finnish Institute of Occupational Health).
      Role on platform
      Optional, embedded in the wellbeing check-in.
    • ONS-4 (Office for National Statistics Personal Wellbeing)

      Purpose
      Four-item personal wellbeing measure: life satisfaction, worthwhile, happiness, anxiety.
      Licence
      Open Government Licence v3.0. Free, no registration.
      Role on platform
      Rolling out as a 4-weekly cadence item alongside the existing wellbeing check-in. Aggregate trend will appear on dashboards once enrolment threshold is met.
    • Custom Work-Impact Items

      Purpose
      Plain-language items on appointment burden, side effects, disclosure choices.
      Licence
      Authored in-house. CC BY-NC 4.0 for re-use.
      Role on platform
      Drives employer and clinic dashboard work-impact panels.

    4 rules

    Aggregation and Anonymity

    Dashboards never expose individual responses. Aggregates are produced by Postgres SECURITY DEFINER functions that apply k-anonymity gates before returning rows.

    • Employer Dashboard

      Aggregates appear once 250 users have contributed to the employer's dataset.

      Within that, every breakdown bucket (stage, role band, age band) requires at least 50 users.

    • Clinic Dashboard

      Aggregates appear once 50 people have chosen to share with the clinic (clinic cohorts are smaller).

      Within that, every breakdown bucket requires at least 25 users.

    • Suppression

      Buckets below threshold render as 'too few users to show'.

      Numerator and denominator are never returned to the client.

    • Row-Level Security

      Postgres RLS ties every read to the caller's user_roles row.

      Employer admins can only see their own employer_id; clinic admins their own clinic_id.

    5 consents

    Consent Model

    Five separate consents, all unticked until the person ticks them. Each is per-user and versioned, every change is logged, and the sharing choices are editable from Settings.

    • 1

      Health Information Storage

      Required at sign-up (unticked box)

      Agreement to Her Holistic Health Ltd storing the health information the person enters, plus a separate "I am 18 or over" tick.

      Wording, version and time are recorded.

    • 2

      Employer Consent

      Default off (you choose)

      Permits anonymous inclusion in the person's own employer group figures, above the k-anonymity gates above.

      Independent toggle. An access code never turns it on.

    • 3

      Clinic Consent

      Default off (you choose)

      Permits anonymous inclusion in the person's own clinic group figures, above the clinic gates above.

      Independent toggle.

    • 4

      Research Consent

      Default off (you choose)

      Explicit opt-in for anonymised aggregate research and academic research collaborations.

      Captured per study with version stamp.

    • 5

      Email Updates

      Default off

      Explicit opt-in. Marketing is never sent without it.

    Governance and Regulatory Framing

    OccuFertility is not a medical device, not software as a medical device (SaMD), and not a diagnostic tool.

    It is an information resource and a set of templates that users hand to their own GP, line manager, or occupational health team.

    Data controller: Her Holistic Health Ltd, ICO registration ZB841609.

    Content is authored by Dr Divpreet Sacha (MBChB MRCGP DOccMed) and reviewed against NICE fertility guidance, ACAS workplace guidance, and the Equality Act 2010.

    Crisis copy directs to NHS 111 (Mental Health, Option 2) and Samaritans (116 123) only.

    References, source material, and methodology updates are versioned and visible at /demo/research.

    Source code review is available on request for academic and commissioning partners under NDA.

    Researcher or Commissioner?

    Send an enquiry for the methodology pack, an anonymised aggregate sample, or pilot partnership terms.

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