Although I agree that there is in some quarters an excessive emphasis on image resolution as indicated by pixel counts, it is a great exaggeration to say that this is the only thing being emphasized.
If your shooting still life, landscapes or shooting for pleasure rather than commerce or editorial, then just about any camera/back will work, obvously some better than others.
If your working professionally, then the "important" list should be much longer than defraction, pixel count, or image resolution.
1. Is the camera and back reliable. I mean does it have to go into service every year or for that matter ever? Does it overshoot, jam, have to be reconnected, burn through batteries.
2. Does it tether reliably. Do you need special firewire powered repeaters to work with a variety of computers or when tethering will the back allow itself to be self powered so you can run a 30 ft. cable to the computer. Trust me on this, nobody wants to get stuck at 10 or 15 ft. as through the day you just won't move around to the positions you need to be in to explore something unique.
3. Is the software stable. Can you plug and unplug withouit issue, restarts or crashes. Nothing is a buzz kill worse than watching a tech muddle through the ups and downs of trying to fix anything on set.
4. Is the software intuitive. Honestly can you plug the camera into the computer, set a collection folder and shoot sans digital tech?
5. Does the lcd work when tethered. Medium format lcd's are challanged at best, but during pressured production running over to the computer to see if the last frame was ok will wear you out.
6. Is the file format out of camera generic. Will it work in almost any 3rd party software without any type of conversion regardless of compression. Nothing adds to workflow like taking raws, converting them, then trying out other software. Nothing doubles storage space like a system that requires you to convert the files. Do you then toss the originals, or keep them just in case. The ability to just drag a file into lightroom, RD or photoshop without drama is almost mandatory in my world because regadless of look, style, post processing, any file that goes to a retoucher usually requires a raw file so they can add detail when needed. Can a retoucher process your original file.
7. Are the file formats all the same, tethered/non tethered. Once again step back and think worse case sceanrio. Your shooting tethered, but you see a beautiful image of a model in makeup. Can you yank the firewire cord, throw in a cf card and just just a handfull of images without having to go back into the makers software to convert them for use. Worse case sceanrio 2. The generator dies, the computer fails, can you just shoot non tethered drag and copy images without worrying about the format.
8. Is the camera maker transparent. Will they actually take a phone call, answer a problem, get back on an e-mail in a day, not a week. Believe you when you say you have half black frames, or green previews, or do they say check the firewire cable, or talk to you like it's the first time you've held a camera in your hand. Do they have expert tech on hand in most major countries or do you have to file support cases and wait for replies.
9. This holds true for dealers. Price savings is one thing, interfering with a project is another. Does the dealer answer their phone that minute, give you cell phone numbers, late night numbers, do they stand behind everything they promised at purchase.
10. Is the system full featured. Are all the lenses and accessories available. I hear all the time the Contax is a dead system or nobody wants to use an H series on anything but a blad back because it is now a locked down system. Forget that thought because there is so much product from those two systems floating around it's harder not to find something than to actually find it. With any new system you going to have to wait on lenses, finders, grips. Do you need to send it in to update firmware. Who can guess when or if they need their system intact.
11. Is the software released on time, or when the maker promises. Now in medium format the answer is NO because all of the medium format makers have missed their own deadlines, though does the older software still work reliably and if so then you can continue working while the makers figure out how to get their software out in a stable fashion.
12. Can you use this camera/back for 5 years. These things, even at today's reduced prices are expensive and we're getting past the point of always buying new stuff for an extra 20% in detail, or 14% faster.
13. Will the dealer/maker give you real world references from people they don't have deals with. Can you call Joe or Jill and find out what their real experiences are like. Can you get the complete unvarnished truth.
14. Which camera/back or dslr do you use for the job of your life. The carreer changing job that makes or breaks you. Which camera do you pull out of the bag and do you trust the camera without backup. I personally wouldn't shoot anything without multiple backups, but when you look around the room which one is the most reliable, which one will not keep you from working.
15. Can you rent one if yours goes down, or even worse case scenario 3 can you be in any major world city and buy one off the shelf.