I just started running 48/16 (stock on the Kilo I just got) up some pretty decent hills on a daily basis, and I love it. The higher ratio just makes it easier to go balls out than to pace yourself, which I guess could be a drawback but if I wanted to go slow and steady I think I'd just ride a 10 speed.

Skidding is kinda tough, but it's really not that hard. The single skidpatch is the only (huuuge) reason I really want to change the ratio. Plus when you go back DOWN the big hills, the low ratio is definitely preferable, in my opinion, since spinning a little slower seems to make it easier to apply resistance than when your legs are a blur under you.