
The Epistaxis Severity Score (ESS) assesses nosebleed severity in hereditary hemorrhagic telangiectasia (HHT) patients. The ESS exhibited excellent test-retest reliability but indicated low internal consistency, implying its measurement of disparate concepts. Factor analysis revealed three related but distinct constructs underlying the ESS. While the ESS captures overall severity effectively, it may not adequately assess different dimensions of epistaxis severity. To enhance accuracy, additional correlated survey questions and sub-scores are suggested, acknowledging the need for a comprehensive evaluation of individual ESS items.
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