I have also seen these and found them interesting.
I can't answer your questions with 100% certainty, but I'm pretty sure you would need a DCC system to do any setup or programming it might need. Pretty sure you would have to make some selections or something on the decoder.
Also may need to convert AC to DC and reduce the voltage. Not a problem with inexpensive converters available on ebay. I imagine DCC decoders would need 12VDC for power as that is I believe what all the N & HO stuff requires to operate. The car would need pick up rollers to, or some way to get power.
The larger O gauge cars would allow for a better speaker than they use in HO so I don't think sound would be an issue.
I'm sure it could somehow be made to work in O gauge though. If I ever get caught up with my ordering from these new catalogs that keep coming out I might get more serious about giving it a try. Funds seem to always be depleted for quite sometime after a new catalog comes out, then another one comes out...
