A nationwide Belgian randomized trial reported that genome sequencing diagnosed 39.8% of developmental disorder cases, outperforming the standard combination of exome sequencing and chromosomal microarray. The study included 567 patients and quantified a clear diagnostic yield advantage for whole-genome sequencing. The results provide evidence supporting sequencing strategy decisions in publicly funded diagnostics and highlight the gap that exists when lower-resolution approaches miss structural variation, noncoding changes, or complex variants captured better by genome-wide methods. For biotech companies building sequencing workflows, the trial strengthens the case for pipeline support around WGS interpretation, variant prioritization, and clinical reporting standards.