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Most efficient way to tell if any database content has changed
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Would a simple directory listing suffice? 

It is independent of file size.

I mainly use Unix terminals, so:

ls -lai cfd_20201009_0146.sqlite

gives:
6553669 -rw-r--r-- 1 root root 200912896 Oct  9 12:53 cfd_20201009_0146.sqlite

Windows has similar and Android too. (with a bit of effort)