monster hunter world pc's use of SwitchToThread seems like it might have been done to be analogous to their ps4 and xbox backends, without really understanding the implications, since both of those consoles' kernels have different thread scheduling behavior compared to desktop OSes. which would explain why SpecialK is so effective just by disabling that alone?
this is conjecture really, but maybe MHW is actually really well optimized and we just can't see it without tweaks, because they fumbled some of the port work.