head to head
Dr. Mario Online Rx asks more than Super Mario World, and the gap is reads.

Execution · Pure Mechanics
A falling-capsule puzzle testing speed placement to clear virus layouts.

Execution · Pure Mechanics
Precise jump execution across fixed levels with secrets to memorise.
Dr. Mario Online Rx leans Execution (Pure Mechanics); Super Mario World leans Execution (Pure Mechanics).
Dr. Mario Online Rx leans a little harder on execution, though the gap is small.
Dr. Mario Online Rx
Fast capsule placement under speed-up is the lead skill
Super Mario World
Perfect inputs trivialise every jump, spin and cape flight
Dr. Mario Online Rx leans clearly harder on reads.
Dr. Mario Online Rx
Versus play adds light anticipation of opponent tempo
Super Mario World
Scripted Koopas adapt to nothing
Dr. Mario Online Rx leans clearly harder on variance.
Dr. Mario Online Rx
Capsule colors are random but quickly mappable
Super Mario World
Levels are fixed; nothing hidden survives one playthrough
Dr. Mario Online Rx leans a little harder on optimization, though the gap is small.
Dr. Mario Online Rx
Clearing virus layouts has known efficient patterns
Super Mario World
Secret exits and route knowledge add a modest solvable layer
A matching score does not mean a matching test. Two games can both sit at 10 on execution and demand completely different things of you - which is why the reasoning above matters more than the number beside it.