EKG vs. XHS

Last updated Jun 24, 2026

EKG (First Trust Nasdaq Lux Digital Health Solutions ETF) and XHS (SPDR S&P Health Care Services ETF) are both Health & Biotech Equities funds - EKG tracks the NASDAQ Lux Health Tech Index while XHS tracks the S&P Health Care Services Select Industry Index. Both are passively managed. Over the past 3 years, EKG returned -0.25%/yr vs 11.29%/yr for XHS. A 0.71 correlation means they provide meaningful diversification when combined. EKG charges 0.65%/yr vs 0.35%/yr for XHS.

Performance

EKG vs. XHS - Performance Comparison

The chart below illustrates the hypothetical performance of a $10,000 investment in First Trust Nasdaq Lux Digital Health Solutions ETF (EKG) and SPDR S&P Health Care Services ETF (XHS). The values are adjusted to include any dividend payments, if applicable.

Returns By Period

In the year-to-date period, EKG achieves a -7.35% return, which is significantly lower than XHS's 15.40% return.

EKG

• 1D: 1.44%
• 1M: 5.58%
• YTD: -7.35%
• 6M: -8.68%
• 1Y: 2.67%
• 3Y*: -0.25%
• 5Y*: —
• 10Y*: —

XHS

• 1D: 0.88%
• 1M: 8.42%
• YTD: 15.40%
• 6M: 14.24%
• 1Y: 28.59%
• 3Y*: 11.29%
• 5Y*: 1.64%
• 10Y*: 8.61%

*Multi-year figures are annualized to reflect compound growth (CAGR)

EKG vs. XHS - Yearly Performance Comparison

	2026 (YTD)	2025	2024	2023	2022
EKG First Trust Nasdaq Lux Digital Health Solutions ETF	-7.35%	11.89%	6.53%	-0.11%	-20.15%
XHS SPDR S&P Health Care Services ETF	15.40%	18.83%	1.76%	5.15%	-15.29%

Correlation

The correlation between EKG and XHS is 0.62, which is moderate. They share some common price drivers but move independently often enough to provide real diversification benefit when combined.

	Correlation
Correlation (1Y) Calculated over the trailing 1-year period	0.62
Correlation (3Y) Calculated over the trailing 3-year period	0.64
Correlation (All Time) Calculated using the full available price history since Mar 23, 2022	0.71

The correlation between EKG and XHS has been stable across timeframes, ranging from 0.62 to 0.71 - a consistent structural relationship.

EKG vs. XHS - Sectors Allocation Comparison

Sectors	EKG	XHS
Healthcare	94.9%	97.9%
Technology	2.6%	-
Basic Materials	-	-
Communication Services	-	-
Consumer Cyclical	-	-
Consumer Defensive	-	-
Energy	-	-
Financial Services	-	2.1%
Industrials	-	-
Real Estate	-	-
Utilities	-	-

Return for Risk

EKG vs. XHS — Risk / Return Rank

Compare risk-adjusted metric ranks to identify better-performing investments over the past 12 months.

EKG

EKG Risk / Return Rank: 10
EKG Sharpe Ratio Rank: 10
EKG Sortino Ratio Rank: 10
EKG Omega Ratio Rank: 10
EKG Calmar Ratio Rank: 10
EKG Martin Ratio Rank: 10

XHS

XHS Risk / Return Rank: 47
XHS Sharpe Ratio Rank: 48
XHS Sortino Ratio Rank: 47
XHS Omega Ratio Rank: 47
XHS Calmar Ratio Rank: 51
XHS Martin Ratio Rank: 43

The rank (0–100) shows how this investment's returns compare to the risk taken. Higher = better. Based on the past 12 months of data, combining Sharpe, Sortino, and other metrics used by quantitative funds and institutional investors.

EKG vs. XHS - Risk-Adjusted Trends Comparison

This table presents a comparison of risk-adjusted performance metrics for First Trust Nasdaq Lux Digital Health Solutions ETF (EKG) and SPDR S&P Health Care Services ETF (XHS). Risk-adjusted metrics are performance indicators that assess an investment's returns in relation to its risk, enabling a more accurate comparison of different investment options.

Values are calculated on a 1-year rolling basis and updated daily. Risk-adjusted metrics are more stable over longer periods — use the period switch above to explore them.

	EKG	XHS	Difference
Sharpe ratio: Return per unit of total volatility	0.12	1.60	-1.48
Sortino ratio: Return per unit of downside risk	0.33	2.21	-1.88
Omega ratio: Gain probability vs. loss probability	1.04	1.29	-0.25
Calmar ratio: Return relative to maximum drawdown	0.12	2.39	-2.27
Martin ratio: Return relative to average drawdown	0.26	6.63	-6.37

EKG vs. XHS - Sharpe Ratio Comparison

The current EKG Sharpe Ratio is 0.12, which is lower than the XHS Sharpe Ratio of 1.60. The chart below compares the historical Sharpe Ratios of EKG and XHS, calculated using daily returns over the previous 12 months. A higher Sharpe Ratio indicates better risk-adjusted performance relative to the risk-free rate.

Drawdowns

EKG vs. XHS - Drawdown Comparison

The maximum EKG drawdown since its inception was -43.82%, which is greater than XHS's maximum drawdown of -39.32%. Use the drawdown chart below to compare losses from any high point for EKG and XHS.

Drawdown Indicators

	EKG	XHS	Difference
Max Drawdown Largest peak-to-trough decline	-43.82%	-39.32%	-4.50%
Max Drawdown (1Y) Largest decline over 1 year	-22.09%	-11.99%	-10.10%
Max Drawdown (3Y) Largest decline over 3 years	-34.49%	-17.81%	-16.68%
Max Drawdown (5Y) Largest decline over 5 years	—	-32.62%	—
Max Drawdown (10Y) Largest decline over 10 years	—	-39.32%	—
Current Drawdown Current decline from peak	-18.36%	0.00%	-18.36%
Average Drawdown Average peak-to-trough decline	-22.59%	-10.16%	-12.43%
Ulcer Index Depth and duration of drawdowns from previous peaks	10.17%	4.32%	+5.85%

Volatility

EKG vs. XHS - Volatility Comparison

First Trust Nasdaq Lux Digital Health Solutions ETF (EKG) has a higher volatility of 8.01% compared to SPDR S&P Health Care Services ETF (XHS) at 4.47%. This indicates that EKG's price experiences larger fluctuations and is considered to be riskier than XHS based on this measure. The chart below showcases a comparison of their rolling one-month volatility.

Volatility by Period

	EKG	XHS	Difference
Volatility (1M) Calculated over the trailing 1-month period	8.01%	4.47%	+3.54%
Volatility (6M) Calculated over the trailing 6-month period	17.55%	12.25%	+5.30%
Volatility (1Y) Calculated over the trailing 1-year period	22.29%	17.92%	+4.37%
Volatility (5Y) Calculated over the trailing 5-year period, annualized	27.08%	21.13%	+5.95%
Volatility (10Y) Calculated over the trailing 10-year period, annualized	27.08%	22.40%	+4.68%

EKG vs. XHS - Expense Ratio Comparison

EKG has a 0.65% expense ratio, which is higher than XHS's 0.35% expense ratio.

Dividends

EKG vs. XHS - Dividend Comparison

EKG has not paid dividends to shareholders, while XHS's dividend yield for the trailing twelve months is around 0.22%.

Position	TTM	2025	2024	2023	2022	2021	2020	2019	2018	2017	2016	2015
EKG First Trust Nasdaq Lux Digital Health Solutions ETF	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%	0.00%
XHS SPDR S&P Health Care Services ETF	0.22%	0.27%	0.38%	0.23%	0.19%	0.20%	0.23%	2.37%	0.34%	0.22%	0.28%	0.93%

Frequently Asked Questions

Can I hold both EKG and XHS in my portfolio?

EKG and XHS have a correlation of 0.62, meaning they provide meaningful diversification benefit when combined. Depending on your allocation goals, holding both could reduce overall portfolio risk.

Which is riskier, EKG or XHS?

EKG has higher volatility (8.01%) compared to XHS (4.47%). In terms of maximum drawdown, EKG dropped -43.82% vs XHS's -39.32%.

Which ETF is better, EKG or XHS?

On 3-year performance, XHS leads with 11.29% vs -0.25% for EKG. On fees, XHS is cheaper at 0.35% per year. On volatility, XHS has been the lower-risk option at 4.47%. The better choice depends on whether you care most about return, fees, risk, or income.

Which ETF has performed better, EKG or XHS?

Over the 3-year period, XHS has performed better with a 11.29% return vs -0.25%. Past performance does not guarantee future results, so compare this with risk, fees, and fund exposure.

Which ETF is cheaper, EKG or XHS?

XHS is cheaper with a 0.35% expense ratio, compared with 0.65% for EKG.

Which ETF pays a higher dividend yield, EKG or XHS?

XHS has the higher dividend yield at 0.22%, compared with 0.00% for EKG.

What is the main difference between EKG and XHS?

EKG tracks NASDAQ Lux Health Tech Index, while XHS tracks S&P Health Care Services Select Industry Index. They also come from different issuers: First Trust and State Street. Their fees differ too: 0.65% for EKG and 0.35% for XHS.

Which has better risk-adjusted returns?

XHS currently has the higher Sharpe Ratio (1.60 vs 0.12), meaning it's delivered slightly more return per unit of risk over the trailing 12 months. However, this ranking shifts over time - use the Risk/Return Score above for a more comprehensive view that combines Sharpe, Sortino, and other measures used by quantitative funds.