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Patchwerk is stand and deliver DPS, named after the patchwerk raid encounter.
Meanwhile helter skelter provides more movement (although tbqh I don't remember the details of the top of my head).
They are both "accurate" in that they both simulate what they ask you too. Each raid encounter is different, with varying amounts of movement and standing still to deliver.
There is no "right" or "wrong" answer.
Helter-Skelter simulations randomly interrupts casting and melee uptime for short intervals to give a very approximate idea of how you'll perform under a real fight environment. Patchwerk assumes a stationary boss with 100% uptime.
I find, at least for my spec, that helter-skelter gives an underestimate and patchwerk is a vast overestimate of my performance. Some specs will be affected more heavily by movement than others. The larger the gap between the two models gives you a rough idea of how much of a penalty you're going to take for movement and other fight mechanics.
"Helter Skelter" style single target: No cleave fight with regular movement, raid-wide stuns, interrupts, player distraction, and target switching. This is a more realistic fight that highlights each specs maximum DPS under typical raid conditions, with a fight length typically of 360sec - 540sec and non-optimal uses of raid buffs.
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