head to head
Fallout: New Vegas asks more than Medieval II: Total War, and the gap is execution.

Optimization · Pure Optimization
A faction-driven RPG-shooter where build and route planning shape every ending.

Optimization · Pure Optimization
Grand strategy wargame mixing turn-based empire play with real-time battles.
Fallout: New Vegas leans Optimization (Pure Optimization); Medieval II: Total War leans Optimization (Pure Optimization).
Fallout: New Vegas leans clearly harder on execution.
Fallout: New Vegas
Shooter inputs with VATS assist
Medieval II: Total War
real-time battle micro is modest
Same score on reads - which means the number cannot separate them. The difference is in what each one asks of you.
Fallout: New Vegas
Scripted factions and enemies
Medieval II: Total War
campaign AI is exploitable and mappable
Medieval II: Total War leans a little harder on variance, though the gap is small.
Fallout: New Vegas
Some loot and crit RNG
Medieval II: Total War
fog of war and event triggers hide some state
Medieval II: Total War leans a little harder on optimization, though the gap is small.
Fallout: New Vegas
Faction routing, perks, builds heavily rewarded
Medieval II: Total War
economy, unit counters, and campaign map strategy dominate
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.