^There is a big difference between VHQ (Very High Quality) and Medium.
When you take shadows and lightning down on most engines you get large FPS bumps. Perhaps I'll do a caparison on my system for Watch Dogs Medium vs VHQ. These sliders we get are why a lot of people can still run new games like this with very old hardware. And to be honest, it still looks pretty good, the high end settings imo you get the law of diminishing returns kicking in.