In 2015 at the 1st SIPMeL National Congress, a working group developed a proposal for a list of the five procedures with the highest risk of inappropriateness. The list was discussed and approved. In the following months additional comments and proposals were gathered; no procedure reached greater consensus than the five originally listed. The National Council approved them. In 2023, the EBLM Working Group (WG) of SIPMeL was tasked to evaluate whether the first 5 SIPMeL recommendations of 2017 were still valid and, if they were, to update the bibliography. The WG proceeded with the update; the updated list was approved by the National President on June 15, 2023 and was sent to Choosing Wisely for evaluation.