I reviewed the published empirical evidence concerning journal peer review, which consisted of 68 papers, all but three published since 1975. Peer review improves quality, but its use to screen papers has met with limited success. Current procedures to assure quality and fairness seem to discourage scientific advancement, especially important innovations, because findings that conflict with current beliefs are often judged to have defects. Editors can use procedures to encourage the publication of papers with innovative findings such as invited papers, early-acceptance procedures, author nominations of reviewers, results-blind reviews, structured rating sheets, open peer review, and, in particular, electronic publication. Some journals are currently using these procedures. The basic principle behind the proposals is to change the decision from whether to publish a paper to how to publish it.