Assessment of the Surveillance Interval at 1 Year after Curative Treatment in Hepatocellular Carcinoma: Risk Stratification

( Minjong Lee ),( Young Chang ),( Sohee Oh ),( Young Youn Cho ),( Dhong-eun Jung ),( Hong Hyun Kim ),( Joon Yeul Nam ),( Hyeki Cho ),( Eun Ju Cho ),( Jeong-hoon Lee ),( Su Jong Yu ),( Nam-joon Yi ),( 대한간학회 2018 Gut and Liver Vol.12 No.5

Background/Aims: Guidelines recommend surveillance for hepatocellular carcinoma (HCC) recurrence at 3-month intervals during the first year after curative treatment and 6-month intervals thereafter in all patients. This strategy does not reflect individual risk of recurrence. We aimed to stratify risk of recurrence to optimize surveillance intervals 1 year after treatment. Methods: We retrospectively analyzed 1,316 HCC patients treated with resection/radiofrequency ablation at Barcelona Clinic Liver Cancer stage 0/ A. In patients without 1-year recurrence under 3-monthly surveillance, a new model for recurrence was developed using backward elimination methods: training (n=582)/ validation cohorts (n=291). Overall survival (OS) according to risk stratified by the new model was compared according to surveillance intervals: 3-monthly versus 6-monthly (n=401) after lead time bias correction and propensity-score matching analyses. Results: Among patients without 1-year recurrence, age and international normalized ratio values were significant factors for recurrence (hazard ratio [HR], 1.03; 95% confidence interval [CI], 1.00 to 1.03; p=0.009 and HR, 5.63; 95% CI, 2.24 to 14.18; p<0.001; respectively). High-risk patients stratified by the new model showed significantly higher recurrence rates than low-risk patients in the validation cohort (HR, 1.73; 95% CI, 1.18 to 2.53; p=0.005). After propensity-score matching between the 3-monthly and 6-monthly surveillance groups, OS in high-risk patients under 3-monthly surveillance was significantly higher than that under 6-monthly surveillance (p=0.04); however, OS in low-risk patients under 3-monthly surveillance was not significantly different from that under 6-monthly surveillance (p=0.17). Conclusions: In high-risk patients, 3-monthly surveillance can prolong survival compared to 6-monthly surveillance. However, in low-risk patients, 3-monthly surveillance might not be beneficial for survival compared to 6-monthly surveillance. (Gut Liver 2018;12:571-582)

Post-polypectomy surveillance: the present and the future

Masau Sekiguchi,Takahisa Matsuda,Kinichi Hotta,Yutaka Saito 대한소화기내시경학회 2022 Clinical Endoscopy Vol.55 No.4

An appropriate post-polypectomy surveillance program requires the effectiveness of reducing colorectal cancer and safety. In addition,the post-polypectomy surveillance program should consider the burden of limited medical resource capacity, cost-effectiveness, andpatient adherence. In this sense, a risk-stratified surveillance program based on baseline colonoscopy results is ideal. Major internationalguidelines for post-polypectomy surveillance, such as those from the European Union and the United States, have recommendedrisk-stratified surveillance programs. Both guidelines have recently been updated to better differentiate between high- and low-risk individuals. In both updated guidelines, more individuals have been downgraded to lower-risk groups that require less frequent or nosurveillance. Furthermore, increased attention has been paid to the surveillance of patients who undergo serrated polyp removal. Previousguidelines in Japan did not clearly outline the risk stratification in post-polypectomy surveillance. However, the new colonoscopyscreening and surveillance guidelines presented by the Japan Gastroenterological Endoscopy Society include a risk-stratifiedpost-polectomy surveillance program. Further discussion and analysis of unresolved issues in this field, such as the optimal follow-upafter the first surveillance, the upper age limit for surveillance, and the ideal method for improving adherence to surveillance guidelines,are warranted.

Current Status of the National Liver Cancer Surveillance Program in Korea

권진원,최하진,서재경,신상진 한국보건의료기술평가학회 2017 보건의료기술평가 Vol.5 No.2

Objectives: Surveillance for liver cancer has been shown to improve survival via earlier cancer detection. Although liver cancer surveillance is conducted at national level in Korea, little is known of the diagnostic performance and adherence to this surveillance, especially in a real surveillance setting. The purpose of this study was to evaluate the adherence and diagnostic accuracy of the liver cancer surveillance in real practice setting in Korea. Methods: We used the National Health Insurance Service claims data linked with the National Liver Cancer Surveillance Program (NLCSP) from 2013 to 2015. We analyzed the surveillance adherence and diagnostic accuracy. Sensitivity, specificity, and positive predictability values were assessed based on patients diagnosed with liver cancer within 3, 6, or 12 months after undergoing surveillance during the study period. Results: The annual surveillance rate resulted that individuals undergoing the NLCSP was 41.2% in 2014. Female, the younger, and people with less comorbidity and more income received more surveillance. The sensitivity of the surveillance program was 37.0% and 40.4% for positive predictive value and it was varied depending on the criteria used to define the diagnosis of liver cancer. Conclusion: This study highlights the current status of the NLCSP and the needs for continues efforts to help improve the current surveillance practice in quantitative and qualitative to fulfil the goal of NLCSP.

SYMPOSIUM 3 : Surveillance of Hepatocellular Carcinoma

( Do Young Kim ) 대한간학회 2013 춘·추계 학술대회 (KASL) Vol.2013 No.1

Hepatocellular carcinoma (HCC) is an appropriate cancer to apply surveillance program for early cancer detection. Currently, liver ultrasonography (US) combined with serum biomarker, alpha-fetoprotein (AFP), measurement every 6 months is the standard method of HCC surveillance in Korea. Although US is the most widely used tool, its sensitivity in early HCC (within Milan criteria) detection during surveillance is only 63%. AFP is the representative biomarker for both HCC surveillance and diagnosis. The unsatisfactory performance of AFP as a surveillance tool requires discovery of novel biomarker or combination with other serum markers. In this regard, des-gamma-carboxy prothrombin (DCP) and AFP-L3 could be candidate biomarkers which are complementary to AFP. However, there is no evidence that shows the superiority of AFP+DCP compared to AFP alone in HCC surveillance. It also remains to be addressed whether highly-sensitive AFP-L3 could show better performance in HCC surveillance compared with AFP. Regarding surveillance interval, current data indicate that 6 month-interval is most appropriate if US is the principal tool. When an innovative surveillance imaging instead of US is developed, optimal surveillance interval would be rediscussed. The strategies of HCC surveillance are different in countries according to health care policy as well as available resources and degree of insurance coverage. The accurate prediction of HCC development in population at risk has been an important issue to clinicians and so a few studies combined various risk factors to estimate the probability of HCC occurrence. Many studies have revealed that surveillance increases the survival rate in HBV carriers and patients with cirrhosis by detecting HCC with earlier stages amenable to curative treatments such as resection, ablation, and liver transplant. Thus, currently, accumulated evidences suggest that surveillance for early HCC detection is no longer recommendation, but becoming a standard of care in clinical practice. The outcome of HCC surveillance is not still satisfactory to most of physicians and so needs more progress to achieve higher rate of early HCC detection and improved patient survival. Undoubtedly, discovery of novel biomarkers and invention of new imaging technology are keys toward successful HCC surveillance in patients at risk.

Effectiveness of Regular Surveillance for Hepatocellular Carcinoma in a Korean Cohort

( Hwi Young Kim ),( Jeong-hoon Lee ),( Joon Yeul Nam ),( Hye Ah Lee ),( Young Youn Cho ),( Eunju Cho ),( Su Jong Yu ),( Yoon Jun Kim ),( Jung-hwan Yoon ) 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1

Aims: It is still controversial whether the regular surveillance for hepatocellular carcinoma (HCC) in subjects who have risk factors improves their prognosis. This study aimed to investigate the effectiveness of HCC surveillance in a large-scale cohort. Methods: A total of 1,412 patients who were newly diagnosed with HCC at a single tertiary hospital were enrolled. HCCs were diagnosed either during regular surveillance (defined as participation in >80% of imaging intervals being ≤6 months during before at least 2 years) in 844 patients or irregular surveillance in 104; the remained 464 patients were diagnosed due to symptoms or accidently without surveillance. The primary endpoint was overall survival (OS) and the secondary endpoints included initial tumor stage. Results: Median follow-up duration was 44.8 (range, 0.2-106.6) months. Both the regular- (adjusted hazard ratio [aHR], 0.62; 95% confidence interval [CI], 0.51-0.74; P<0.001) and irregular-surveillance groups (aHR, 0.76; 95% CI, 0.56-1.04; P=0.09) showed significantly longer OS than the no-surveillance group after adjustment for ECOG, HCC stage, treatment modality, and lead-time bias (based on tumor doubling time of 90 days). Moreover, surveillance regularity affects the OS (regular vs. irregular surveillance: HR, 0.72; 95% CI, 0.53-0.97; P=0.03). The 5-year OS rate were 69.0%, 56.7%, and 28.2% in the regular-, irregular-, and no-surveillance groups, respectively. Compared to the no-surveillance group, both the irregular- and regular- surveillance groups showed significantly earlier initial HCC stage (BCLC 0 or A ratio: 26.9%, 40.4%, and 64.7%, respectively; P<0.001). Conclusions: Surveillance for HCC is associated with longer OS after adjusting lead-time bias and early detection of HCC. Regular surveillance provides more survival benefit than irregular surveillance.

디지털 환경의 감시와 역감시 현상에 대한 고찰-영화 <감시자들>과 <아이 인 더 스카이>를 중심으로-

신성환 ( Shin Sung Hwan ) 한양대학교 현대영화연구소 2018 현대영화연구 Vol.14 No.2

현대인의 삶을 산다는 것은 수많은 기계의 눈들이 얽혀 있는 감시와 역감시의 장에서 과잉 노출을 감수하면서 생활한다는 말에 다름 아니다. 감시기술의 효용성과 부작용에 대한 양가적 입장도 복잡하게 상존하는 실정이다. 본 논문은 영화 <감시자들>과 <아이 인 더 스카이>를 통해 첨단 시각기계를 활용한 감시와 역감시의 관계성을 살펴보고, 인공적 시선의 유토피아에서의 주체적이고 윤리적인 보기의 가능성을 모색하였다. 두 영화는 모두 ‘기술적 감시’를 핵심 소재이자 주제로 삼아, 우리 시대 감시권력이 필연적으로 내포할 수밖에 없는 사회적·윤리적 폐해와 치부를 드러내며, 감시의 양가적 상존성을 숙고하게 하였다. 영화 분석을 위해, 기술이 개입된 시각 체계의 위험성을 주목하여 시각기계에 의존하는 보기가 결국 인간 주체성을 상실하고 정교한 원격 감시 체계를 초래한다는 폴 비릴리오의 이론을 활용하였다. <감시자들>은 첨단 감시 테크놀로지로 무장한 감시반 경찰들과 천재적인 범죄자와의 첨예한 ‘시선의 전쟁’을 그린다. 특히 여주인공은 적극적으로 시각기계 되기를 시도하여 자신의 감각과 지각을 기계의 기능처럼 작동함으로써 사건을 해결한다. 영화는 시민들의 자발적 동의와 함께 전면적인 감시 시스템이 확장되어 막강한 권력을 행사하고 개인을 무력하게 만들 역기능을 은연중에 드러낸다. <아이 인 더 스카이>는 현대 드론 전쟁의 실상과 피해를 적나라하게 보여준다. 단, 시각 테크놀로지를 통해 대상을 상세히 들여다볼 수 있게 되는 경우 연민과 공감 등 인간적인 감정이 더 강화될 수도 있지 않을까 하는 점도 반성적으로 전망한다. 첨단 시각 테크놀로지는 이제 인간이 주도적으로 다루고 관리할 수 있는 기술적 수준을 넘어선 것으로까지 보인다. 지속적으로 감시자의 자격을 묻고 역감시의 필요성을 강변하는, 기술 바깥의 비판능력이 더욱 요구되는 이유이다. 동시에 감시 테크놀로지를 사용하는 이와 함께 사용되는 이들의 윤리도 이야기해야 할 것이다. This study examines the relationship between surveillance and counter-surveillance using advanced visual technologies and searched for the possibility of subjective and ethical view in utopia of gaze. In the digital environment, we live with overexposure in everyday life of surveillance and counter-surveillance where the eyes of many machines are intertwined. There is also a dual position on the utility and side effects of surveillance technology. The movies < Cold eyes > and < Eye in the sky > both use technical surveillance as a central theme, revealing the social and ethical implications of surveillance power inevitably, and pondering the multiple possibilities of surveillance. This study utilized Paul Virilio’s theory that the view that depends on the visual machine ultimately results in a sophisticated remote surveillance system. < Cold eyes > deals with a sharp ‘gaze battle’ between police officers armed with superior surveillance techniques and genius criminals. In particular, the heroine actively tries to become a visual machine, solves the case by acting as a machine function of her senses and perception. This movie exposes the dysfunctions that make the individual helpless by expanding the overall surveillance system with the voluntary consent of the citizens. < Eye in the sky > presents the truth and the damage of the modern drone war nakedly. This movie, on the other hand, reflects on the possibility that human emotions such as compassion and sympathy can be strengthened if the visual technology allows us to see the object in detail. Now a more critical viewpoint is needed to constantly ask for the qualification of surveillance and to point out the necessity of counter-surveillance. At the same time, we should talk about their ethics used together with the use of surveillance technology.

유비쿼터스 감시에 대한 비판적 분석

권기욱(Keewook Kweon) 사이버커뮤니케이션학회 2016 사이버 커뮤니케이션 학보 Vol.33 No.4

본 연구는 유비쿼터스 감시가 작동하게 된 사회적 배경을 고찰하고, 유비쿼터스 감시가 작동하는 메커니즘을 분석하고자 하였다. 유비쿼터스 감시의 사회적 배경은 신자유주의시대의 감시, 소비자본주의시대의 감시, 테러의 시대의 감시로 나누어 볼 수 있다. 먼저 신자유주의시대에서는 시장의 불안정성으로 인한 사회적 불안이 증폭되고 이런 불안을 해소하기 위해 유비쿼터스 감시와 통제를 활용한다. 또한 감시와 통제의 상당 부분이 민간 자본으로 이양되어 국가권력과 자본권력이 합작하여 피지배층에 대한 감시를 수행한다. 둘째, 소비자본주의시대에는 소비주의가 나타남에 따라 자본은 시장에서의 소비자들에 대한 유비쿼터스 감시를 실행하게 된다. 그럼으로 인해 소비자의 기호에 맞는 상품을 제공하거나 소비자를 시장에 길들이기도 하며 소비자본주의를 침해하는 사람들을 배제시키기도 한다. 셋째, 테러의 시대에는 상이한 감시체계들 간의 수렴과 통합이 전 지구적으로 이루어지며, 테러에의 공포와 그에 따른 감시를 이용하여 국가가 국민들을 강압적으로 통치한다. 한편 유비쿼터스 감시의 작동원리는 파놉티콘과 동의에 의한 감시 두 가지가 동시에 발생한다. 먼저 유비쿼터스 감시는 비가시성에 따른 시선의 불균형, 편재성에 따른 감시의 자동화, 지능화에 따른 감시주체의 이동을 순차적으로 가져온다. 결과적으로 유비쿼터스 감시에서는 감시자 자체가 불필요해지고 유비쿼터스 감시기제 자체가 감시자 역할을 수행하게 된다. 둘째, 동의에 의한 감시는 지배층의 헤게모니가 피지배층의 동의를 획득하여 개인들의 프라이버시에 대한 권리를 포용하는 양상을 보인다. 피지배층은 유비쿼터스 사회의 서비스를 누리기 위해서 일정 정도의 감시에 대한 동의를 하게 되고 이미 지배층의 헤게모니에 포섭되어 있는 프라이버시 시스템에 동의하게 된다. 이런 유비쿼터스 감시를 극복하기 위해서 지배층이 사용하는 유비쿼터스 기술 그 자체를 지배층에 대한 역감시에 활용하는 시놉티콘을 제안한다. This study examines the social background and analyzed the mechanism of ubiquitous surveillance. Social background of ubiquitous surveillance can be divided into surveillance of the neoliberal era, surveillance of the consumer capitalism era, and surveillance of the terrorism era. First, in the era of neoliberalism, the instability of the market promotes social unrest and ubiquitous surveillance and control are used in order to eliminate this unrest. In addition, a significant portion of the surveillance and control is handed over to private capital, then the state power and capital power performs the surveillance of the people together. Second, in the era of consumer capitalism, consumerism makes capital to perform ubiquitous surveillance of consumers in the market. So capital provide products that match the taste of the consumers, adapt consumers to market, and exclude people who infringe consumer capitalism from the society. Third, in the era of terrorism, convergence and integration among the different surveillance systems in the global dimension and nations govern the people forcibly with fear of terrorism and following surveillance. On the other hand, the operating mechanisms of ubiquitous surveillance work like panopticon and surveillance by consent at once. First ubiquitous surveillance brings the imbalance of attention due to the invisibility, automation of surveillance due to the ubiquity, and change of the monitor due to the intelligentization sequentially. As a result, the monitor itself is not required and ubiquitous surveillance mechanism itself carries out a monitor role. Second, hegemony of ruling class obtain the consent of the people and embrace the right to privacy of individuals. The people agree to a certain degree of surveillance in order to enjoy the services of the ubiquitous society and the privacy system which is already subsumed in the hegemony of the ruling class. To overcome this ubiquitous surveillance, I propose synopticon which utilize ubiquitous technology itself that is used by the ruling class on the monitoring for ruling class.

A Population Health Surveillance Theory

Farouk El Allaki,Michel Bigras-Poulin,Pascal Michel,André,Ravel 한국역학회 2012 Epidemiology and Health Vol.34 No.-

OBJECTIVES: Despite its extensive use, the term ¨Surveillance¨ often takes on various meanings in the scientific literature pertinent to public health and animal health. A critical appraisal of this literature also reveals ambiguities relating to the scope and necessary structural components underpinning the surveillance process. The authors hypothesized that these inconsistencies translate to real or perceived deficiencies in the conceptual framework of population health surveillance. This paper presents a population health surveillance theory framed upon an explicit conceptual system relative to health surveillance performed in human and animal populations. METHODS: The population health surveillance theory reflects the authors’ system of thinking and was based on a creative process. RESULTS: Population health surveillance includes two broad components: one relating to the human organization(which includes expertise and the administrative program), and one relating to the system per se (which includes elements of design and method) and which can be viewed as a process. The population health surveillance process is made of five sequential interrelated steps: 1) a trigger or need, 2) problem formulation, 3) surveillance planning, 4) surveillance implementation, and 5) information communication and audit. CONCLUSIONS: The population health surveillance theory provides a systematic way of understanding, organizing and evaluating the population health surveillance process.

파놉티콘의 강화 혹은 역감시?

전현재(Hyunjae Jeon),조주은(Jooeun Cho) 한국사회조사연구소 2015 사회연구 Vol.- No.28

최근 자동차 블랙박스가 확산되면서 블랙박스에 의한 감시가 증가하고 있다. 사람들은 사고 발생시 억울한 일을 당하지 않기 위해 블랙박스를 구입하고, 블랙박스로 자기 자신을 감시한다. 블랙박스 감시는 두 가지 측면에서 파놉티콘 감시와 구분되는 탈파놉티콘 감시의 특징을 지닌다. 하나는 블랙박스가 정보통신기술을 이용하는 디지털화된 감시 도구이며, 다른 하나는 파놉티콘 감시하에서 감시 대상이던 개인이 감시 주체가 되었다는 점이다. 이 연구에서는 블랙박스동호회의 인터넷 게시판을 통하여 사람들이 블랙박스로 무엇을 하는지, 구입 의도대로 자기 보호를 위해서만 블랙박스를 사용하는지, 아니면 다른 용도로도 사용하는지, 그리고 블랙박스가 기존의 감시체제에 어떤 영향을 미치는지를 분석하였다. 분석 결과를 요약하면 다음과 같다. 첫째, 사람들은 블랙박스로 자기 자신, 타인, 보험회사 등 다양한 대상을 감시하면서 감시 주체로서의 정체성을 확립하고 있었다. 구입 목적과는 달리 자기 보호보다 타인 감시에 블랙박스를 더 많이 활용하였다. 둘째, 인터넷 동호회는 일종의 시놉티콘으로 작용하였는데, 일반 대중이 블랙박스 이용의 모델을 제시하고, 여론 형성에 영향을 미쳤다. 셋째, 블랙박스 감시는 ‘신고’ 행위를 통해 감시 어셈블리지에 연결되고, 파놉티콘 감시 권력을 강화시켰다. 넷째, 블랙박스와 그에 의한 신고가 일상화되면서 사람들은 블랙박스감시를 내면화하고, 감시에 대한 사회적 수용도가 높아졌다. 마지막으로 사고발생시 보험회사가 판단한 과실비율에 문제를 제기하는 역감시가 이루어지고 있었다. 즉, 다수가 소수를 감시하는 또다른 시놉티콘을 발견할 수 있었다. 결론적으로 개인에 의한 블랙박스 감시는 파놉티콘 감시체제를 강화시키는 동시에 역감시도 수행하고 있었다. The dashboard camera is now an essential part of an automobile, which entails increasing surveillance by the cameras. dash-board cameras, or dash-cams, are useful in assessing responsibility in an accident and for reporting traffic violations. Dash-cam surveillance is different from panopticon surveillance in two aspects. First, dash-cam is a digitalized surveillance tool based on information technology. Secondly, the individual, who was being watched under the panopticon surveillance, is now the active surveillant. This study analyzes internet bulletin boards of an online dash-cam club and examines whom people watch, why they do it, what the surveillance behavior means to them, and what effects the new surveillance system has on the old system. The results are as follows. First, people watch various targets such as themselves, others, and insurance companies, and in doing so they establish their identity as active surveillants. Secondly, the online dash-cam club works as a kind of synopticon. In the club, a layperson can suggest a models in which to use the dash-cam, influencing public opinion. Thirdly, dashcams are connected to the surveillance assemblage through the acts of reporting, therefore strengthening the panopticon surveillance. Fourthly, as dash-cams are now a part of everyday life and reporting crimes/violations based on their video footage is common, people have become accustomed to the surveillance by dash-cams and the social acceptance of the surveillance has significantly increased. Lastly, insurance companies’ decisions regarding who is at fault in a car accident are often disputed by dash-cam videos, which can imply a synopticon situation where the majority exercise watch over the minority. In summary, while the dash cam surveillance over individuals has strengthened the panopticon surveillance system, it has simultaneously operated as the synopticon surveillance system.

3D 시각노출도를 이용한 문화재 범죄예방환경의 평가

김충식 ( Kim Choong-sik ) 한국전통조경학회(구 한국정원학회) 2017 한국전통조경학회지 Vol.35 No.1

문화재의 범죄예방환경에서 중요한 요인 중의 하나인 감시강화는 현장평가와 진단에 어려움이 있다. 이로 인해 감시강화는 문화재 형상, 지형, 수목 등을 디지털로 모델링하여 컴퓨팅 기술로 평가하는 접근이 이루어진다. 본 연구는 입체형상으로 감시강화를 정량적으로 평가할 수 있는 3차원 시각노출도 지표(3DVE, 3D Visual Exposure)를 이용하여 문화재 범죄예방환경의 평가기법을 개발하는 것을 목적으로 하였다. 연구를 위해 평가요인을 자연적 감시, 조직적 감시, 기계적 감시 그리고 통합적 감시로 세분하여 분석을 수행하였다. 분석을 위해서 건물, 지형, 담장, 수목 등의 형상을 입체적으로 모델링하였으며, Unity 3D를 이용하여 분석 프로그램을 제작하였다. 사람의 작업영역을 고려하여 머리위치와 허리위치로 구분하여 감시지점을 분석할 수 있도록 하였다. 분석 프로그램으로 3DVE의 활용 가능성을 검증하기 위해 논산에 소재한 돈암서원(사적 제383호)을 디지털로 모델링하여 범죄예방환경을 평가하였다. 연구결과 돈암서원의 자연적 감시, 기계적 감시, 조직적 감시에서 취약지점, 사각지대, 순찰동선의 문제점 등의 발견이 가능하였다. 3DVE 분석결과를 3차원 도면으로 제작함으로써 위치와 대상을 명확하게 표현할 수 있었다. 주간 감시성은 자연적 감시, 기계적 감시, 조직적 감시 순으로 높지만, 야간 감시성은 조직적 감시, 기계적 감시, 자연적 감시 순으로 높게 나타났다. 작업영역의 위치가 낮을수록 차폐되기 용이하므로, 허리위치에 대한 평가가 이루어질 필요가 있는 것으로 파악되었다. CCTV의 제원과 설치 위치, 높이에 따른 감시범위를 산출하게 됨으로써 사각지대의 발견과 표시가 가능하게 되었다. 기계적 감시의 보완효과가 있는 것으로 밝혀진 조직적 감시는 범죄취약 시간대에 분석이 요구된다. 또한 보안등, CCTV, 순찰동선 등의 설정을 검토하는데 통합적 감시도 분석이 효과적일 수 있다. 본 연구는 실제를 시뮬레이션으로 제작하여 범죄예방환경을 진단할 수 있는 성과를 거두었다. 본 연구를 기반으로 범죄예방환경설계의 대안을 평가하고 비교할 수 있는 연구가 수행되어야 한다. Strengthening surveillance, one of the most important factors in the crime prevention environment of cultural heritages, has difficulty in evaluating and diagnosing the site. For this reasons, surveillance enhancement has been assessed by modelling the shape of cultural heritage, topography, and trees digitally. The purpose of this study is to develop the evaluation method of crime prevention environment for cultural heritage by using the 3D visual exposure index (3DVE) which can quantitatively evaluate the surveillance enhancement in three dimensions. For the study, the evaluation factors were divided into natural, organizational, mechanical, and integrated surveillance. To conduct the analysis, the buildings, terrain, walls, and trees of the study site were modeled in three dimensions and the analysis program was developed by using the Unity 3D. Considering the working area of the person, it is possible to analyze the surveillance point by dividing it into the head and the waist position. In order to verify the feasibility of the 3DVE as the analysis program, we assessed the crime prevention environment by digitally modeling the Donam Seowon(Historic Site No. 383) located in Nonsan. As a result of the study, it was possible to figure out the problems of patrol circulation, the blind spot, and the weak point in natural, mechanical, and organizational surveillance of Donam Seowon. The results of the 3DVE were displayed in 3D drawings, so that the position and object could be identified clearly. Surveillance during the daytime is higher in the order of natural, mechanical, and organizational surveillance, while surveillance during the night is higher in the order of organizational, mechanical, and natural surveillance. The more the position of the work area becomes low, the more it is easy to be shielded, so it is necessary to evaluate the waist position. It is possible to find out and display the blind spot by calculating the surveillance range according to the specification, installation location and height of CCTV. Organizational surveillance, which has been found to be complementary to mechanical surveillance, needs to be analyzed at the vulnerable time when crime might happen. Furthermore, it is note that the analysis of integrated surveillance can be effective in examining security light, CCTV, patrol circulation, and other factors. This study was able to diagnose the crime prevention environment by simulating the actual situation. Based on this study, consecutive researches should be conducted to evaluate and compare alternatives to design the crime prevention environment.