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IntroductionLaughter has positive, quantifiable physiological and psychological effects on certain aspects of health. In the clinical setting, laughter interventions can be used with preventive intent (lifestyle medicine) or as a complementary or alternative therapeutic option to other established therapeutic strategies. Although the medical community has been reluctant to embrace and support laughter for health, laughter interventions are increasingly being implemented as a routine clinical practice in its therapeutic portfolio. However, the therapist will have to know, understand and manage the various techniques available to experience positive emotions (including hilarity-humour) and types of therapeutic laughter (spontaneous, simulated and stimulated). This review discusses laughter techniques for therapeutic use in medicine. Discussion A therapeutic laughter intervention usually consists of a minimum of three stages: (a) opening and warm-up; (b) experiencing laughter and (c) recovery, evaluation and closure. Breathing; facial and body gymnastics; laughter placing, intonation and releasing techniques are used in the beginning of each laughter intervention, both as a mental/ physical warm-up and as a disinhibition practice. Within the experiencing stage, spontaneous laughter is mainly derived from any kind of playing, clowning, dancing, move-

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Spontaneous laughter, unrelated to one's own free will, is triggered by different (external) stimuli and positive emotions. Simulated laughter is triggered by oneself at will (self-induced, self-initiated, voluntary), with no specific reason (purposeful, unconditional), and therefore not elicited by humor, fun, other stimuli or positive emotions. And stimulated laughter happens as a result of the physical contact or action (reflex) of certain external stimuli (tickle, hugs, massages, others). Therapeutic value of laughter would concern in particular the first two types, Volume 8 Issue 2-2017 Lifestyle Medicine Network, Spain

A447and optimise the reporting of such evaluations. To our knowledge, there are no such published guidelines in Spain. Methods: This guidance was designed with the main aim of providing authors with recommendations, in the form of a checklist, to optimise design and reporting of EE and BIA to be submitted to the Catalan Health System (CatSalut) within its harmonization program for pharmaceutical innovation. Results: For a given evaluation, two separate guidelines with corresponding checklists assess its methodology, quality, and reporting based on several dimensions. ConClusions: The steps outlined in this first guidance in Spain, although not compulsory, will provide useful practical tips for how to go about designing and reporting of an EE or a BIA for pharmaceuticals in Catalonia (Spain).