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Objectives: To examine the effect on peer review of asking reviewers to have their identity revealed to the authors of the paper.

Design: Randomised trial. Consecutive eligible papers were sent to two reviewers who were randomised to have their identity revealed to the authors or to remain anonymous. Editors and authors were blind to the intervention.

Main outcome measures: The quality of the reviews was independently rated by two editors and the corresponding author using a validated instrument. Additional outcomes were the time taken to complete the review and the recommendation regarding publication. A questionnaire survey was undertaken of the authors of a cohort of manuscripts submitted for publication to find out their views on open peer review.

Results: Two editors' assessments were obtained for 113out of 125manuscripts, and the corresponding author's assessment was obtained for 105 …