Ultimately there is no fool proof risk free system. Which system is right for you depends on where you are sailing and with whom you are sailing.There is zero confusion regarding what happens next with a satellite SARSAT device. None. Just saying.
So what DOES happen with this AIS thing and it’s duplicate MMSI when the Chinese fire drill begins? It calls your boat? What if you are singlehanding? What if mom is sleeping? What if everyone on board went overboard?
Suppose it triggers a DSC rodeo: Does the radio light up with the usual cast of characters asking for radio checks who somehow figure out that an emergency situation is ongoing and it involves your sailboat...and yes, it appears that your boat is motoring just fine? Does the USCG get involved, asking that all mariners be on the lookout for your 23’ vessel with leopard-skin topsides which has declared an emergency? What happens then? Does a radio committee form up ad hoc, would anyone have a clue that this isn’t a boat emergency, it is a MOB emergency? Suppose the radio committee had no AIS capability. Suppose the radio response committee had a ships radio with some add-on AIS screen with blinking dots. Remember, these are the radio-check guys, this is the modern USCG watchstander service model, and this is DIY rescue.
A personal AIS beacon is pretty worthless while crossing an ocean solo. An EPIRB satellite system is far better.
However, sailing in a relatively high traffic coastal area on a crewed boat will make the AIS based system a better system. The crew will immediately know a member has fallen overboard and the location will show up on the chart plotter virtually instantaneously. In addition every AIS enabled chart plotter within 5 miles will light up with a distress signal.
The Rescue 21 system set up by the CG has coverage out 20 miles from shore. It is able to receive distress calls from 1 watt radios at sea level. See the charts here: https://www.navcen.uscg.gov/?pageName=mtNds
In the Chesapeake and on the coastal waters most of us sail, an AIS is a much better choice.
Of course if you sailing in and around Point Nemo, an EPIRB is the way to go but it will still be a long wait for someone to find you.