ID

38777

Description

Study ID: 109035 Clinical Study ID: 109035 Study Title: A Randomised, Double-Blind, Parallel-Group, Placebo-Controlled Study Evaluating the Efficacy and Safety of GSK163090 in Subjects With Major Depressive Disorder Patient Level Data: Study Listed on ClinicalStudyDataRequest.com Clinicaltrials.gov Identifier: NCT00896363 Sponsor: GlaxoSmithKline Collaborators: N/A Phase: Phase 2 Study Recruitment Status: Completed Generic Name: GSK163090 1 mg, GSK163090 Placebo, GSK163090 3 mg Trade Name: Study Indication: Depressive Disorder

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Versions (1)
  1. 11/3/19 11/3/19 -
Copyright Holder

GlaxoSmithKline

Uploaded on

November 3, 2019

DOI

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License

Creative Commons BY-NC 3.0
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Efficacy and Safety of GSK163090 in Subjects with Major Depressive Disorder; NCT00896363

English

CRB Electronic Signature Affidavit

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CRB Electronic Signature Affidavit
Description

CRB Electronic Signature Affidavit

Alias
UMLS CUI-1
C2346576
By my dated signature below, I, (First Name) (Last Name) verify that this case report form accurately displays the results of the examinations, tests, evaluations and treatments performed on this patient.
Description

Investigator Name

Data type

text

Alias
UMLS CUI [1]
C2826892
Date
Description

Investigator Signature, Date in time

Data type

date

Alias
UMLS CUI [1,1]
C2346576
UMLS CUI [1,2]
C0011008
Investigator Signature
Description

Investigator Signature

Data type

text

Alias
UMLS CUI [1]
C2346576
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CRB Electronic Signature Affidavit

1 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
CRB Electronic Signature Affidavit
C2346576 (UMLS CUI-1)
Investigator Name
Item
By my dated signature below, I, (First Name) (Last Name) verify that this case report form accurately displays the results of the examinations, tests, evaluations and treatments performed on this patient.
text
C2826892 (UMLS CUI [1])
Investigator Signature, Date in time
Item
Date
date
C2346576 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
Investigator Signature
Item
Investigator Signature
text
C2346576 (UMLS CUI [1])
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