  In observational studies, unobserved confounding is a major barrier in
isolating the average causal effect (ACE). In these scenarios, two main
approaches are often used: confounder adjustment for causality (CAC) and
instrumental variable analysis for causation (IVAC). Nevertheless, both are
subject to untestable assumptions and, therefore, it may be unclear which
assumption violation scenarios one method is superior in terms of mitigating
inconsistency for the ACE. Although general guidelines exist, direct
theoretical comparisons of the trade-offs between CAC and the IVAC assumptions
are limited. Using ordinary least squares (OLS) for CAC and two-stage least
squares (2SLS) for IVAC, we analytically compare the relative inconsistency for
the ACE of each approach under a variety of assumption violation scenarios and
discuss rules of thumb for practice. Additionally, a sensitivity framework is
proposed to guide analysts in determining which approach may result in less
inconsistency for estimating the ACE with a given dataset. We demonstrate our
findings both through simulation and an application examining whether maternal
stress during pregnancy affects a neonate's birthweight. The implications of
our findings for causal inference practice are discussed, providing guidance
for analysts for judging whether CAC or IVAC may be more appropriate for a
given situation.
