A restricted working group, appointed by the Executive Committee of ISDE-Italian, drafted a proposal for 9 at risk of inappropriate practices: into account the special nature and purpose of institutional ISDE, some have turned to the role of the doctor, other for citizens . After extensive discussion were selected 5 Practices at risk of appropriateness, which, even after consultation and suggestions of the responsible of the project “Doing more does not mean do better”, have been definitively approved by the National Executive Board of Italy section of ISDE. Recommendations 3 and 5 were revised in October 2018. The recommendations were all revised in April 2021. Recommendations 2 and 5 were revised in February 2024 too.