I see this from 3 points of view as an instructor, technition, and end user. And the first thing I'd like to adress is all the instructors referancing the out of air drills we practice in the pool and test in the open water. The idea of an OOD aproaching their buddy to indicate to them they want their octo is simply not reality. An out of air diver is going to grab for any available reg with air going to it. If it is the octo yes a slimline will provide air in any orientation (I'll get to the performance later), BUT what may also be likely to happen is the OOD is not going to waste time looking for an octo (I know should be adressed in the pre-dive safety check but this step tends to be overlooked, especially by the types that run out of air) they are going to grab the obvious one that they know works, your primary. My opinion is thats a case for an integrated octo.
As a technition I can tune those slimlines to the same specs as the primary. However I don't. Unless the octo has a user adjustment on it I tune it back to prevent free flow, slimline or not. Customers tend to complain about free flowing regs, but if they request an easy breathing octo I'm more than happy to ablige.
As an end user if I run out of air I'm really not all that concerned about the performance of the octo, I'm just happy to have air. When you have to resort to the octo your dive is over, time to ascend (controled of course). I have both styles slimline and standard 2nd stage octo, on 2 different reg sets. When using the standard 2nd, even in training I have never seen anyone adjust the user control knob to make it breath easier. Even after demonstrating to do it moments before the skill. And guess what, my standard 2nd stage with the knob all the way closed breaths the same as a detuned slimline.
So as I see it, performance aside have an octo that works and practice safe diving so you never have to worry about the performanse of the octo.