In the stroke risk factor validation, also using a patient chart review process, although global sensitivity was lower with ICD-10, coding was generally found to be similar between ICD-9 and 10. Atrial fibrillation, coronary artery disease/ischemic heart disease, diabetes mellitus, and hypertension were all identified with a high degree of confidence, as well as, resulted in a high specificity and sensitivity with regard to coding. Alternatively, cerebrovascular disease, hyperlipidemia, renal failure, and tobacco use were identified to a lesser degree and coding results ranged from poor to excellent, with low sensitivity but high specificity.

The authors suggest that, although their data provides evidence that ICD-10 does not out-perform ICD-9 in coding accuracy for stroke and stroke risk factors, ICD-10's greater clarity in definitions may provide a qualitative advantage.