Just took the plunge and upgraded from a 7800GT to a Sapphire X1900XT after acquiring one from MM for a paltry £245 and all I can say is... well err... not much actually because im too busy touching myself in intimate places over the performance boost its given me (please try not to think about that in too much detail). 
Installation wasn't without its hitches though. In order to be sneaky and also test out a theory that you didnt need to reformat in order to go from NV to ATI I uninstalled all nvidia motherboard drivers and display drivers, ran drivercleaner from safe mode, and then went through my registry with a fine toothcomb removing every Nvidia entry that had been missed in order to avoid a reformat and then turned the PC off. I then switched off, took out the XFX 7800GT, and tenderly placed the X1900 in there. I switched the power button on and... and... 3 LED's of doom from my DFI SLI-DR. Arrgh! The fans powered up it just didnt boot. Resetting CMOS 3 times did nothing so I entered full panic mode and had dark visions of blowing my mobo/PCI-E slot or PSU. The PSU im using aint the best you see, being a Thermaltake 470w (have another one on order), so was convinced itd gone toots up. It took a ten minute CMOS reset with the power cord unplugged from the PSU to finally boot, for some reason the mobo really didn't like me swapping out the 7800GT for the X1900 without a heavy CMOS reset... weird. Anyway, the card was then working and the fun commenced.
I am also happy to report that a reformat wasn't necessary, ive had no errors in games and it appears that I managed to meticulously nuke all NV entries from my computer, so if you're careful enough you really can get away with going from NV to ATI without a reformat (although some doubltess prefer to, I just REALLY couldn't be arsed as i've done it so often this year!). I installed the Omega 6.3's and away I went!
My native res is now a demanding 1680*1050 due to my fantabalastic 20.1" NEC MultiSync 20WGX2 20.1" (best LCD monitor in existence imo) and the difference in performance in games has been absolutely astounding!
I fired up 3DMARK2005 for a quick untweaked run and got just over 10k, in aquamark I got a slightly sucky 77k but then again i'm running a pretty pants CPU by my standards, bit of a temporary job until I get a bit more cash. Anyway here's just a few opinions on my experiences with it in games etc so far with the following system:
3000+ Venice @ 2.7ghz
DFI SL-DR
2GB Samsung UCCC
X1900XT @ stock using Omega 6.3's.
Oblivion
With my XFX 7800GT Oblivion could run at 1680*, but I had all sliders pretty much down to half, most shadows disabled, water effects on low/med and no distant landscapes/buildings enabled. Grass was also set to less than half in order to maintain tolerable framerates, and even then it was hitting 15fps outside in woodland etc. Now with my X1900XT ALL graphical details are maxed, distant everything is on, and it never dips below 23fps even in forests... and the grass is on as far as the eye can see, not to mention the landscape LOD mods downloaded from TES which massively improve the resolution of the dstant textures and adds bump-mapping etc. Performance has essentially doubled or tripled in cases, and at much higher settings to boot. To say this makes me pleased is like saying Lisa Riley is big-boned.
COD 2
Another game that had crucified my 7800GT. At 1680* in DX9 mode it had been jerky and frequently falling to sub 20fps, and at about 3/4 of max details (also no AA or AF). On my X1900 I have everything maxed and its not dropping below 30fps in heavy firefights... and did I mention this is with 4x AA enabled too? The game just looks so ******* good I can't believe it, again performance has just about doubled!
Image quality
I have heard people drone on about "ATI's image quality being better" for some time and have never really paid it much heed, in fact in todays GPU situation its not that relevant considering the overall quality of the cards from both Nvidia and ATI. However I can state uncategorically that there is a discernible difference in ATI's favour, the textures are noticeably clearer and this was most evident in Star Wars: Empire at War which I have been staring at for a long while now with the Nvidia 7800GT. The difference isn't going to change the world but it is there and I have looked at this completely objectively when looking for the difference... I have no bias to any brand.
Stock cooler
The dreaded ATI "stock cooler", a name told to frighten small children at night with tales of its dragons breath heat, and fan roar that would put a Boeing 747 to shame. I even ordered a Zalman vf900cu before I got the card in anticipation of the intolerable cooler tha card would come with. Umm, what's the fuss please? The cooler is loud for about 2 seconds on startup and then goes downto a level consistant with the rest of my case (33dba or so). I played oblivion and COD2 for a while and the noise never changed, not once did I hear this feared "jet engine" racket that people warned me of. Idle temperatures are 43c and I havent seen it go above 65c yet, but I will be looking into this further. Very tempted to just send the Zalman back to OCUK but i'll give it a couple of days before I decide for definate.
I'll stop now at the risk of droning on but just conclude in saying that this card is completely and utterly jaw-droppingly awesome, and I thought I had become a bit jaded when it came to PC hardware. This is the first ATI card i've had in my rig since the glory days of the 9800PRO and I am very, very impressed on all accounts. Performance in the most intensive games has gone through the roof, allowing me to max all details as well as stick 4xAA on for "free" in the majority of cases, and image quality is superb.
I haven't even tried overclocking it yet, but i'll get it up to XTX speeds tonight using ATI Tool as ATI Tray Tools seems to not support the card yet. Not sure if it has the faster RAM but guess i'll find out later.
What a great card, i'll add more later when I have chance to play around with it more!
EDIT - After figuring out how to OC the damn thing it is now sitting pretty at XTX speeds. I know it has a lot more in it but temps have been reaching 80s at load with these speeds. Im going to try the Zalman (heard very mixed reports about it) today and see if that makes a difference, though to be perfectly honest how it can hope to beat the stock cooler is beyond me, the fan is whisper quiet and the cooling looks far less heavy duty. Not an OC'ers heatsink methinks, and I may swap it out for an X2 as I hear those are good coolers and very under-rated.

Installation wasn't without its hitches though. In order to be sneaky and also test out a theory that you didnt need to reformat in order to go from NV to ATI I uninstalled all nvidia motherboard drivers and display drivers, ran drivercleaner from safe mode, and then went through my registry with a fine toothcomb removing every Nvidia entry that had been missed in order to avoid a reformat and then turned the PC off. I then switched off, took out the XFX 7800GT, and tenderly placed the X1900 in there. I switched the power button on and... and... 3 LED's of doom from my DFI SLI-DR. Arrgh! The fans powered up it just didnt boot. Resetting CMOS 3 times did nothing so I entered full panic mode and had dark visions of blowing my mobo/PCI-E slot or PSU. The PSU im using aint the best you see, being a Thermaltake 470w (have another one on order), so was convinced itd gone toots up. It took a ten minute CMOS reset with the power cord unplugged from the PSU to finally boot, for some reason the mobo really didn't like me swapping out the 7800GT for the X1900 without a heavy CMOS reset... weird. Anyway, the card was then working and the fun commenced.

I am also happy to report that a reformat wasn't necessary, ive had no errors in games and it appears that I managed to meticulously nuke all NV entries from my computer, so if you're careful enough you really can get away with going from NV to ATI without a reformat (although some doubltess prefer to, I just REALLY couldn't be arsed as i've done it so often this year!). I installed the Omega 6.3's and away I went!
My native res is now a demanding 1680*1050 due to my fantabalastic 20.1" NEC MultiSync 20WGX2 20.1" (best LCD monitor in existence imo) and the difference in performance in games has been absolutely astounding!
I fired up 3DMARK2005 for a quick untweaked run and got just over 10k, in aquamark I got a slightly sucky 77k but then again i'm running a pretty pants CPU by my standards, bit of a temporary job until I get a bit more cash. Anyway here's just a few opinions on my experiences with it in games etc so far with the following system:
3000+ Venice @ 2.7ghz
DFI SL-DR
2GB Samsung UCCC
X1900XT @ stock using Omega 6.3's.
Oblivion
With my XFX 7800GT Oblivion could run at 1680*, but I had all sliders pretty much down to half, most shadows disabled, water effects on low/med and no distant landscapes/buildings enabled. Grass was also set to less than half in order to maintain tolerable framerates, and even then it was hitting 15fps outside in woodland etc. Now with my X1900XT ALL graphical details are maxed, distant everything is on, and it never dips below 23fps even in forests... and the grass is on as far as the eye can see, not to mention the landscape LOD mods downloaded from TES which massively improve the resolution of the dstant textures and adds bump-mapping etc. Performance has essentially doubled or tripled in cases, and at much higher settings to boot. To say this makes me pleased is like saying Lisa Riley is big-boned.
COD 2
Another game that had crucified my 7800GT. At 1680* in DX9 mode it had been jerky and frequently falling to sub 20fps, and at about 3/4 of max details (also no AA or AF). On my X1900 I have everything maxed and its not dropping below 30fps in heavy firefights... and did I mention this is with 4x AA enabled too? The game just looks so ******* good I can't believe it, again performance has just about doubled!
Image quality
I have heard people drone on about "ATI's image quality being better" for some time and have never really paid it much heed, in fact in todays GPU situation its not that relevant considering the overall quality of the cards from both Nvidia and ATI. However I can state uncategorically that there is a discernible difference in ATI's favour, the textures are noticeably clearer and this was most evident in Star Wars: Empire at War which I have been staring at for a long while now with the Nvidia 7800GT. The difference isn't going to change the world but it is there and I have looked at this completely objectively when looking for the difference... I have no bias to any brand.
Stock cooler
The dreaded ATI "stock cooler", a name told to frighten small children at night with tales of its dragons breath heat, and fan roar that would put a Boeing 747 to shame. I even ordered a Zalman vf900cu before I got the card in anticipation of the intolerable cooler tha card would come with. Umm, what's the fuss please? The cooler is loud for about 2 seconds on startup and then goes downto a level consistant with the rest of my case (33dba or so). I played oblivion and COD2 for a while and the noise never changed, not once did I hear this feared "jet engine" racket that people warned me of. Idle temperatures are 43c and I havent seen it go above 65c yet, but I will be looking into this further. Very tempted to just send the Zalman back to OCUK but i'll give it a couple of days before I decide for definate.

I'll stop now at the risk of droning on but just conclude in saying that this card is completely and utterly jaw-droppingly awesome, and I thought I had become a bit jaded when it came to PC hardware. This is the first ATI card i've had in my rig since the glory days of the 9800PRO and I am very, very impressed on all accounts. Performance in the most intensive games has gone through the roof, allowing me to max all details as well as stick 4xAA on for "free" in the majority of cases, and image quality is superb.
I haven't even tried overclocking it yet, but i'll get it up to XTX speeds tonight using ATI Tool as ATI Tray Tools seems to not support the card yet. Not sure if it has the faster RAM but guess i'll find out later.
What a great card, i'll add more later when I have chance to play around with it more!

EDIT - After figuring out how to OC the damn thing it is now sitting pretty at XTX speeds. I know it has a lot more in it but temps have been reaching 80s at load with these speeds. Im going to try the Zalman (heard very mixed reports about it) today and see if that makes a difference, though to be perfectly honest how it can hope to beat the stock cooler is beyond me, the fan is whisper quiet and the cooling looks far less heavy duty. Not an OC'ers heatsink methinks, and I may swap it out for an X2 as I hear those are good coolers and very under-rated.
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