Publication bias poses a threat to the validity of medical research. It is unlikely that conventional paper journals can solve the problem of selective publication of studies with striking results because of their space limitation and need to be newsworthy. Peer-reviewed electronic journals without limitation of space might provide a solution to this paradox. To maintain the integrity of medical publication, editorial policy needs to be changed to accept clinical trials for publication, based only on the methodological criteria and not on the impact of their findings.