| Course | PA 650 Capstone Project |
|---|---|
| Week | 5 |
| Paper type | Evidence summary table |
| Length | About 580 words, 5 pages |
| Format | APA 7 student paper |
| School | Chamberlain University |
| Program | Master of Physician Assistant Studies (MPAS) |
| Updated | October 2026 |
Free sample paper for PA 650 Week 5
Strength of Evidence Table: One Row per Finding From Three Emergency Department Trials, a Systematic Review and a Guideline, Weighted by How Well Each Fits Adults Discharged on Naproxen
Student Name
Chamberlain University
PA 650: Capstone Project
Instructor Name
Month Day, Year
Strength of Evidence Table: One Row per Finding From Three Emergency Department Trials, a Systematic Review and a Guideline, Weighted by How Well Each Fits Adults Discharged on Naproxen
The Question Stays Above the Table
For working-age adults sent home with new, non-injury back pain that stays above the knee, does a muscle relaxant on top of naproxen give better one-week function than naproxen with a dummy pill?
The Table
Table 1
Evidence on Adding a Muscle Relaxant to Naproxen
| Finding | Study type | In whom | Weight for this question |
|---|---|---|---|
| Cyclobenzaprine added to naproxen: no difference in function at 1 week (mean improvement 10.1 against 9.8 points on the 24-point disability scale) | Randomized, double-blind trial, 323 patients (Friedman et al., 2015) | Adults discharged from one urban emergency department | High: same population, comparison and outcome |
| Diazepam added to naproxen: no difference in function at 1 week (11 points in each arm) | Randomized, double-blind trial, 114 patients (Friedman et al., 2017) | Same setting | Moderate: benzodiazepine, not a typical muscle relaxant |
| Diazepam: more moderate or severe pain at 1 week, 32 percent against 22 percent | Same trial | Same | Moderate; not statistically tested as primary |
| Orphenadrine or methocarbamol added to naproxen: no clinically important difference in function at 1 week | Randomized, double-blind trial, 240 patients (Friedman et al., 2018) | Same setting | High |
| Non-benzodiazepine antispasmodics: pain intensity lower by 7.7 on a 0 to 100 scale within the first fortnight | Systematic review and meta-analysis (Cashin et al., 2021) | Mixed settings, mostly not added to an NSAID | Low: very low certainty, different comparison |
| Same drugs: disability not reduced in that early window | Same review | Same | Low to moderate |
| Same drugs: more adverse events, relative risk 1.6 | Same review | Same | Moderate for harms |
| Guideline: NSAIDs or skeletal muscle relaxants may be chosen when medication is wanted | Clinical practice guideline (Qaseem et al., 2017) | Adults with acute low back pain in general | Low for this question: does not address adding one to the other |
Note. Note. Function measured by the Roland-Morris Disability Questionnaire in the trials.
One Row, One Finding
The diazepam trial appears twice because it reports a function result and a pain result, and they point in slightly different directions. The review appears three times: a benefit, a null and a harm.
Weight Is Fit, Not Just Design
The systematic review sits higher than any single trial in a standard hierarchy, but for this question it fits less well: most of its trials did not add the muscle relaxant to an NSAID, and its pain benefit is rated very low certainty. The Friedman trials fit almost exactly.
Disagreement Kept Adjacent
The review's small pain benefit and the trials' null function results are placed next to each other. They are not contradictory: a small drop in pain intensity can occur without any improvement in what patients can do.
What the Rows Are For
These rows feed the harm and benefit balance next week. They are not yet a recommendation.
Reading down the table, the strongest-fitting rows agree with each other: three trials, three different added drugs, no gain in function at one week. The weaker-fitting rows add a small and uncertain pain signal and a clearer harm signal.
References
Cashin, A. G., Folly, T., Bagg, M. K., Wewege, M. A., Jones, M. D., Ferraro, M. C., Leake, H. B., Rizzo, R. R. N., Schabrun, S. M., Gustin, S. M., Day, R., Williams, C. M., & McAuley, J. H. (2021). Efficacy, acceptability, and safety of muscle relaxants for adults with non-specific low back pain: Systematic review and meta-analysis. BMJ, 374, Article n1446. https://doi.org/10.1136/bmj.n1446
Friedman, B. W., Cisewski, D., Irizarry, E., Davitt, M., Solorzano, C., Nassery, A., Pearlman, S., White, D., & Gallagher, E. J. (2018). A randomized, double-blind, placebo-controlled trial of naproxen with or without orphenadrine or methocarbamol for acute low back pain. Annals of Emergency Medicine, 71(3), 348-356. https://doi.org/10.1016/j.annemergmed.2017.09.031
Friedman, B. W., Dym, A. A., Davitt, M., Holden, L., Solorzano, C., Esses, D., Bijur, P. E., & Gallagher, E. J. (2015). Naproxen with cyclobenzaprine, oxycodone/acetaminophen, or placebo for treating acute low back pain: A randomized clinical trial. JAMA, 314(15), 1572-1580. https://doi.org/10.1001/jama.2015.13043
Friedman, B. W., Irizarry, E., Solorzano, C., Khankel, N., Zapata, J., Zias, E., & Gallagher, E. J. (2017). Diazepam is no better than placebo when added to naproxen for acute low back pain. Annals of Emergency Medicine, 70(2), 169-176. https://doi.org/10.1016/j.annemergmed.2016.10.002
Qaseem, A., Wilt, T. J., McLean, R. M., & Forciea, M. A. (2017). Noninvasive treatments for acute, subacute, and chronic low back pain: A clinical practice guideline from the American College of Physicians. Annals of Internal Medicine, 166(7), 514-530. https://doi.org/10.7326/M16-2367
The Chamberlain PA 650 Week 5 instructions
The fifth week asks for a strength of evidence table in which each row is a single finding. A paper that reports a benefit and a harm appears twice, in different rows. Keep the columns few: what was found, in what kind of study, in whom and how much weight it carries for your question. Weight should reflect fit to your question, not just study design; a well-matched trial can carry more weight than a poorly matched meta-analysis. Keep the question visible above the table. Place findings that disagree next to each other and explain whether they truly conflict. The table does not replace writing about the evidence; it feeds the next step, the balance of harm and benefit. You may use a published grading system or your own stated criteria.
How the PA 650 Week 5 example is put together
The question sits above the table. Eight rows follow: cyclobenzaprine with naproxen showing 10.1 against 9.8 points of improvement in 323 patients (Friedman et al., 2015); diazepam with naproxen showing 11 points in each arm and more moderate or severe pain at 32 against 22 percent (Friedman et al., 2017); orphenadrine or methocarbamol showing no clinically important difference in 240 patients (Friedman et al., 2018); three rows from Cashin et al. (2021) on a small pain reduction, no disability reduction and a relative risk of 1.6 for adverse events; and the Qaseem et al. (2017) guideline. Each row carries a weight for this question. Sections explain splitting rows, weighting the review below the trials because of fit and placing the pain and function results side by side without calling them contradictory.
Reading the PA 650 Week 5 grading rubric
Tables lose the most when a paper occupies one row that blends its benefit and harm results, which hides the trade-off. Next, graders deduct for weight assigned by study design alone, with no account of fit to the question. Faculty reward one finding per row, few columns and the question kept above the table. Placing disagreeing findings together, with an explanation, earns a defined share. Accuracy of numbers against the sources is checked closely. A clear statement that the table feeds the balance rather than replacing the argument shows understanding. Citation of every source in APA form completes the rubric.
Common PA 650 Week 5 mistakes, and how to avoid them
Evidence tables most often fall short by listing studies, not findings, with a column of abstract summaries. Another common problem is ranking a meta-analysis first by habit even when its studies do not match the question. Some also separate disagreeing findings so the conflict is never discussed. If your capstone draws on different studies, send them with your question; a table prepared for you would give each finding its own row, keep the columns lean, weight by fit, set disagreeing rows side by side and keep the question in view. If your program requires GRADE or another grading system, its ratings would be added as a column.
Get a PA-650 Week 5 example written to your instructions
Send the Week 5 instructions, your question, and the column headings your classroom supplies if it supplies any, and a custom strength of evidence table written to your rubric comes back inside 24-48h, the first one free. Say how many rows your section expects and the sample is built to that count rather than to a guess.
More PA 650 papers and MPAS samples
- PA 650 Week 1: Practice Variation Post
- PA 650 Week 2: Question Narrowing Exercise
- PA 650 Week 3: Patient Population Definition
- PA 650 Week 4: Comparison Arm Rationale
- PA 650 Week 6: Harm and Benefit Balance
- PA 650 Week 7: Bedside Recommendation Statement
- PA 650 Week 8: Clinical Poster Draft
- PA 501 Week 5: Supervision Model Comparison
- PA 648 Week 5: Second Attempt Comparison
- PA 502 Week 5: Applicability Write-Up
- PA 503 Week 5: Test Characteristics Problem Set
PA 650 Week 5 questions, answered
Do I have to use a published grading system?
Where your section names one, use it and put your own sentence beside it, because the grade describes the study and the sentence describes the fit. Where none is named, a plain weight column in your own words usually scores better, provided the wording is consistent down the column. What loses ground is a mixture: letters on some rows and prose on others.
How many rows should the table have?
Your section decides where it says so. Otherwise the count follows the parts of the argument rather than a target: enough rows that each claim the project later makes has something under it, and no rows that exist to reach a number. A table with forty rows and a recommendation resting on three of them is a reading list with borders drawn on it.
Does the table replace the writing about the evidence?
Rarely. Most sections want a paragraph under it doing the thing a grid cannot, which is saying what the rows together support and where they run out. Keep that paragraph away from row by row narration, since repeating the table in sentences is the commonest way this part runs long and the easiest thing for a reader to skip.
Where can I find a free PA 650 Week 5 sample paper?
This page has the complete PA 650 Week 5 strength of evidence table on muscle relaxants added to naproxen, with one finding per row.
Why does a single trial outweigh the meta-analysis in the PA 650 Week 5 sample?
The trial matches the question's population, comparison and outcome almost exactly, while most trials in the review did not add the drug to an NSAID.