On the potential for illogic with logically defined outcomes

Logically defined outcomes are commonly used in medical diagnoses and epidemiological research. When missing values in the original outcomes exist, the method of handling the missingness can have unintended consequences, even if the original outcomes are missing completely at random. In this note, we consider 2 binary original outcomes, which are missing completely at random. For estimating the prevalence of a logically defined "or" outcome, we discuss the properties of 4 estimators: the complete-case estimator, the available-case estimator, the maximum likelihood estimator (MLE), and a moment-based estimator. With the exception of the available-case case estimator, all the estimators are consistent. The MLE exhibits superior performance and should be generally adopted.