I hand call 95-98% of the time, and they work well for me.
I did get my start using an e-call, a car AM/FM cassette player, Radio Shack speaker horn and a small 12v. This worked very well for me for a couple of years, and then I started to get fairly decent with hand calls, and that was that.
If I were hunting in more limited sight areas, instead of the wide open spaces of Colorado, I would probably run an e-caller most of the time.
The ability of coyotes to know exactly where I am sitting and calling from is quite amazing, and it should be the same in limited sight areas, so in those spots, an e-caller could make a big difference.