I haven't done much "altitude testing" with this particular engine but did notice a significant bump in EGTs even at slight elevation (~1000m above usual), not even pushing the car just normal driving at low to medium speeds. Some of that increase could be attributed to increased load and stress of uphill driving, some to richer combustion. Hard to tell apart the contribution of each without data but to me it's logical to assume air density plays a significant role. For a detailed analysis you'd really have to record engine parameters like AFR, pressures, temperatures, RPM, throttle and more across various elevated tracks, similar to what manufacturers and developers do when they calibrate stuff like altitude correction.
A mechanical compensator like the one used on the non EGR 1HD-FT from factory could certainly help by adjusting fuel to available air mass and to me that would make an overall improvement for engine health and safety, usability and even fuel consumption, without compromising power at normal altitude and regardless of modifications and tune. In fact, you can make a good argument that it is especially important for a modified engine as you tend to run richer mixtures compared to the factory calibration. There are also a few valid arguments against it (in my opinion): The factory part is discontinued, therefore difficult to source or to find a suitable alternative. It adds some complexity and makes it more challenging to calibrate, requires some testing to set it up properly. Also if you happen to run a performance injector pump most of them don't appear to have a BACS port so adding a compensator isn't possible there either way (unless I missed something). Some of the arguments I've read here, like the unit having a bad quality filter or implying that Toyota added that to the JDM engine for no good reason I find less convincing. Of course there are other measures to take but all things being equal I still think adding a compensator could make a good improvement.