PTH is comprised of 30+ Health Care stocks selected based on a proprietary momentum-based model. Its expense ratio is 0.60% and the ETF has $115 million in assets under management. The strategy relies on technical analysis, but that's not necessarily the issue. Instead, PTH reconstitutes quarterly, forcing managers to wait to buy stocks only after they've made their massive gains. PTH's current holdings illustrate this point perfectly. Although they've gained 51% over the last six months, the ETF itself has declined by 12% over the same period.