What Creative does well is gaming. Their cards support the widest variety of 3D positional sound systems, and they offload more of the calculations involved in such activities from your processor, improving overall performance in demanding games. They do fine in everything else too.
The biggest complaint I hear about Creative cards is that their drivers and utilities are relatively large and complex and resource-hungry, and it can be a chore to install a card and not end up with useless tray icons running for no reason other than to save you a few seconds when you want to change some setting somewhere.
If intense high-framerate gaming isn't a priority, the M-Audio cards are definitely worth looking into. By all accounts they do better in terms of sheer sound quality for music and movies than all but the most expensive Creative cards. And as someone already mentioned, they are more focused on quality than the quantity of features, so they might be a better value if you don't need the extra goodies.
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