Unless you clearly have a problem and know what you're doing, don't screw w/it.

MSCONFIG is a debugging tool. You can uncheck entries in the startup folder to see how it affects startup, but the entries are still there.

Some registry cleaners, like the one I use the most, include a detailed list of startup items (including hidden items) that will give you the name of the item and its exact location, together with the location from which the item starts.

This is a safer way to determine whether or not you need a startup item. Screen shot of a RegCleaner that does this is attached.