Ok, these initial impressons are coming from someone who has never played the board game, but has played the hell out of Elder Sign: Omens (digital). The point is that even though I can't say how this game measures up to the original, I do have some basic idea what's going on from playing a different Lovecraftian game from Fantasy Flight.
That said, I'm not exactly sure what's going on in this game :) It bills itself as a detective game, and starts off by throwing some rote clue-finding at you, but there's no challenge to it other than trying to avoid advancing the Mythos meter (which itself seems a bit arbitrary, since it wasn't clear to me why I shouldn't, for example, try to break open a chest I couldn't unlock). After that, the detecting seems to move to the backseat, at least at the start.
The overwhelming initial impression is that this is some kind of turn-based combat game. I've had several battles so far, which combine the AP system of X-COM with the non-grid-based movement of, say, Baldur's Gate. This is not an ideal marriage, imho, as it is anything but clear where I need to station my investigators so as to block the enemy's movement, or how many AP I will expend to move from A to B until I actually do it, etc. I would call it semi-clunky.
Another weirdness is the way the dead lady speaks in tandem with the investigators investigating her death. It starts happening immediately, with no explanation. It took me a second to realize what was going on. Also, the UI also has some console quirks that will drive PC users batty until they figure them out. The method for dragging and dropping inventory items is non-standard, for example, and difficult to figure out even after having it explained in the tutorial.
The rest--graphics, sound, music, etc.--are all perfectly fine (there's a "Very High" graphics setting in the Options that basically turns everything off instead of on, though. "High" is the one you're looking for). Right now I'm going with 3.5 stars.