Establishment Labs Holdings (FRA:3E0) Piotroski F-Score: 4 (As of Jul. 31, 2026) — Near Median

Establishment Labs Holdings  (FRA:3E0) Piotroski F-Score Explanation

The developer of the system is Joseph D. Piotroski is relatively unknown accounting professor who shuns publicity and rarely gives interviews.

He graduated from the University of Illinois with a B.S. in accounting in 1989, received an M.B.A. from Indiana University in 1994. Five years later, in 1999, after earning a Ph.D. in accounting from the University of Michigan, he became an associate professor of accounting at the University of Chicago.

In 2000, he wrote a research paper called "Value Investing: The Use of Historical Financial Statement Information to Separate Winners from Losers" (pdf).

He wanted to see if he can develop a system (using a simple nine-point scoring system) that can increase the returns of a strategy of investing in low price to book (referred to in the paper as high book to market) value companies.

What he found was something that exceeded his most optimistic expectations.

Buying only those companies that scored highest (8 or 9) on his nine-point scale, or F-Score as he called it, over the 20 year period from 1976 to 1996 led to an average out-performance over the market of 13.4%.

Even more impressive were the results of a strategy of investing in the highest F-Score companies (8 or 9) and shorting companies with the lowest F-Score (0 or 1).

Over the same period from 1976 to 1996 (20 years) this strategy led to an average yearly return of 23%, substantially outperforming the average S&P 500 index return of 15.83% over the same period.

Establishment Labs Holdings Piotroski F-Score Related Terms

The historical data trend for Establishment Labs Holdings's Piotroski F-Score can be seen below:

* For Operating Data section: All numbers are indicated by the unit behind each term and all currency related amount are in USD.
* For other sections: All numbers are in millions except for per share data, ratio, and percentage. All currency related amount are indicated in the company's associated stock exchange currency.

Establishment Labs Holdings Piotroski F-Score Chart

Establishment Labs Holdings Annual Data
	Trend	Dec16	Dec17	Dec18	Dec19	Dec20	Dec21	Dec22	Dec23	Dec24	Dec25
Piotroski F-Score		Get a 7-Day Free Trial					4.00	3.00	2.00	5.00	4.00

Establishment Labs Holdings Quarterly Data
	Jun21	Sep21	Dec21	Mar22	Jun22	Sep22	Dec22	Mar23	Jun23	Sep23	Dec23	Mar24	Jun24	Sep24	Dec24	Mar25	Jun25	Sep25	Dec25	Mar26
Piotroski F-Score	Get a 7-Day Free Trial															4.00	3.00	3.00	4.00	4.00

FRA:3E0 vs TMDX, AXGN, ITGR: Piotroski F-Score Comparison

For the Medical Devices subindustry, Establishment Labs Holdings's Piotroski F-Score, along with its competitors' market caps and Piotroski F-Score data, can be viewed below:

* Competitive companies are chosen from companies within the same industry, with headquarter located in same country, with closest market capitalization; x-axis shows the market cap, and y-axis shows the term value; the bigger the dot, the larger the market cap. Note that "N/A" values will not show up in the chart.

Establishment Labs Holdings Piotroski F-Score vs Medical Devices & Instruments Industry

For the Medical Devices & Instruments industry and Healthcare sector, Establishment Labs Holdings's Piotroski F-Score distribution charts can be found below:

* The bar in red indicates where Establishment Labs Holdings's Piotroski F-Score falls into.

How is the Piotroski F-Score calculated?

* For Operating Data section: All numbers are indicated by the unit behind each term and all currency related amount are in USD.
* For other sections: All numbers are in millions except for per share data, ratio, and percentage. All currency related amount are indicated in the company's associated stock exchange currency.

*Note: If the latest quarterly/semi-annual/annual total assets data is 0, then we will use previous quarterly/semi-annual/annual data for all the items in the balance sheet.

Profitability

Question 1. Return on Assets (ROA)

Net income before extraordinary items for the year divided by Total Assets at the beginning of the year.

Score 1 if positive, 0 if negative.

Establishment Labs Holdings's current Net Income (TTM) was -37.7. ==> Negative ==> Score 0.

Question 2. Cash Flow Return on Assets (CFROA)

Net cash flow from operating activities (operating cash flow) divided by Total Assets at the beginning of the year.

Score 1 if positive, 0 if negative.

Establishment Labs Holdings's current Cash Flow from Operations (TTM) was -29.7. ==> Negative ==> Score 0.

Question 3. Change in Return on Assets

Compare this year's return on assets (1) to last year's return on assets.

Score 1 if it's higher, 0 if it's lower.

Establishment Labs Holdings's return on assets of this year was -0.12222647. Establishment Labs Holdings's return on assets of last year was -0.29934351. ==> This year is higher. ==> Score 1.

Question 4. Quality of Earnings (Accrual)

Compare Cash flow return on assets (2) to return on assets (1)

Score 1 if CFROA > ROA, 0 if CFROA <= ROA.

Establishment Labs Holdings's current Net Income (TTM) was -37.7. Establishment Labs Holdings's current Cash Flow from Operations (TTM) was -29.7. ==> -29.7 > -37.7 ==> CFROA > ROA ==> Score 1.

Funding

Question 5. Change in Gearing or Leverage

Compare this year's gearing (long-term debt divided by average total assets) to last year's gearing.

Score 0 if this year's gearing is higher, 1 otherwise.

Establishment Labs Holdings's gearing of this year was 0.72779334. Establishment Labs Holdings's gearing of last year was 0.72149458. ==> Last year is lower than this year ==> Score 0.

Question 6. Change in Working Capital (Liquidity)

Compare this year's current ratio (current assets divided by current liabilities) to last year's current ratio.

Score 1 if this year's current ratio is higher, 0 if it's lower

Establishment Labs Holdings's current ratio of this year was 2.95633072. Establishment Labs Holdings's current ratio of last year was 3.35607579. ==> Last year's current ratio is higher ==> Score 0.

Question 7. Change in Shares in Issue

Compare the number of shares in issue this year, to the number in issue last year.

Score 0 if there is larger number of shares in issue this year, 1 otherwise.

Establishment Labs Holdings's number of shares in issue this year was 29.947. Establishment Labs Holdings's number of shares in issue last year was 29.476. ==> There is larger number of shares in issue this year. ==> Score 0.

Efficiency

Question 8. Change in Gross Margin

Compare this year's gross margin (Gross Profit divided by sales) to last year's.

Score 1 if this year's gross margin is higher, 0 if it's lower.

Establishment Labs Holdings's gross margin of this year was 0.70055151. Establishment Labs Holdings's gross margin of last year was 0.66382938. ==> This year's gross margin is higher. ==> Score 1.

Question 9. Change in asset turnover

Compare this year's asset turnover (total sales for the year divided by total assets at the beginning of the year) to last year's asset turnover ratio.

Score 1 if this year's asset turnover ratio is higher, 0 if it's lower

Establishment Labs Holdings's asset turnover of this year was 0.63975457. Establishment Labs Holdings's asset turnover of last year was 0.56903177. ==> This year's asset turnover is higher. ==> Score 1.

Evaluation

Good or high score = 7, 8, 9
Bad or low score = 0, 1, 2, 3

Establishment Labs Holdings has an F-score of 4 indicating the company's financial situation is typical for a stable company.

Establishment Labs Holdings Business Description