Is Orthofix Medical, Inc. overvalued or undervalued?

As of 30 April 2021, the valuation grade for Orthofix Medical, Inc. moved from fair to risky, indicating a deterioration in its investment appeal. The company appears overvalued given its negative performance metrics, including a Price to Book Value of 0.94, an EV to Sales ratio of 0.66, and an EV to EBITDA of -27.66. In comparison to peers, Orthofix's EV to EBITDA ratio of -59.0407 is significantly worse than that of Silk Road Medical, Inc. at -18.1243, highlighting its relative underperformance.
The company's recent stock performance has been disappointing, with a year-to-date return of -11.34% compared to the S&P 500's gain of 12.22%, and a 5-year return of -48.14% against the S&P 500's 96.61%. This further reinforces the notion that Orthofix Medical, Inc. is overvalued in its current state.