I haven't tried, or at least care to try, installing the Adrenaline or Crimson software at this time.
I'm not concerned with he heat yet, but I may change my mind in time based on their ability to provide an upgrade. In the meantime, the product is new, and as a result, under warranty. They are currently working on an upgrade but not sure when that will be released. They say that the iMac Pro has the first 'new' SMC in over 10 years. This is a product that I've used for years in my other devices, however according to their website, the iMac pro ships with a new SMC (System Management Controller) which monitors power management, thermal sensors, and fan speed. I'm concerned for now that the lack of fans may be indicative of a sensor problem because if I boot back into macOS, the fans do kick on for a bit to cool it down. The fan never ramps up audibly but plenty of heat comes out of the back. The game never drops below 60 FPS despite have played it for hours on end.
With this, I have played Fallout 4 at 1440P with all other graphic options set to the max. I've followed the thread regarding Alpha testing the drivers since early on and followed the instructions to force install the driver for the Radeon-Pro-Software-17.Q4.1-WHQL-Dec14 set.