We use the extension tools within Visual Studio for comparison (data and schema comparison) and these are much better tools for comparing changes (especially data) to the SSMS scripts.
However, it still requires a lot of manual effort and none of us should be prepared to accept (relatively) unknown changes to our own business structure and data (or clients' that we represent) without fully understanding all of changes and their impact.
We had the change SQL scripts before that were easily used for comparison prior to making 'breaking' changes. We have GitHub for code changes and need an approach for managing data changes.
The new approach to database changes caused us significant amount of time and required comparison of all data and schema changes between 4.3 and 4.4 versions. We had very little guidance to the changes with limited information in the release notes.