I have one that I've used for the last 4K miles on my '03 Ford E-450. The transmission behaviour is much improved and when using cruise control, it no longer shifts down when it sees the first hint of an incline. Now it will go over most freeway overcrossings without down shifting. There's really not a noticable change to engine performance or fuel consumption. They will also tweak it for your personal preferences to some degree. In my case, I had them tweak it so that it won't shift into high gear until about 40 mph. I think they are able to improve the throttle feel on later model year Fords. If you're expecting significant engine performance enhancement, you'll probably be disappointed but if the way your tranny behaves is driving you nuts, you'll probably be happy with it. If you're happy with the initial tune they send you, then you're done. If you want them to tweak it, they'll email you a new tune within a day then you load the emailed tune into the tuner and then install the new tune in your vehicle.